Abstract

BACKGROUND:
Colorectal cancer is the fourth most frequently diagnosed cancer after lung, breast and prostate cancer, and the second leading cause of cancer death after lung cancer globally. Sometimes, distant metastases can cause the initial clinical symptoms. Synchronous metastatic colon cancer define as initially presented metastatic disease.
OBJECTIVE:
To evaluate the clinical presentations of patients with synchronous metastatic colon cancer, the outcome of current chemotherapy protocols used and their toxicity in our center for those  patients , and to correlate the different clinical and pathological parameters in patients with this disease .  
PATIENTS AND METHODS:
This is a hospital based prospective study would hold in Oncology Teaching Hospital Medical City during the period from 1 July 2019 – 1 July 2020. 50 patients would be recruited, all have evaluated by histopathological and radiological parameters, all diagnosed as metastatic colon cancer who are treated with chemotherapy and biological agents. All involved cases would be re-assessed after                  at least 4 cycles of treatment by physical examination, Lab investigations and Survival curve then demonstrate to shows the relation between the outcome and prognostic factors.
RESULTS:
In this study a total of 50 patients were involved ; All of them were diagnosed and treated for synchronous metastatic colonic cancer. the median age of diagnosis was 55.30 years, males in this study were higher than females (56% versus 44%); of enrolled patients 74% were with negative family history.Our study shows that the left side of involvement was the predominant (54%), and         the highest proportion of patients in both groups were with single metastasatic site (52%); and              the liver was the most common single site of metastasis in (40.0%) of patients In both groups,                the most frequent clinical features were altering bowel habit and abdominal pain which reported in (60.0%) the highest proportion of patients in our study were treated with both chemotherapy and target therapy, (78.0%) all of them were receive XELOX {xeloda tablet and oxaliplatin} as chemotherapy and Avastin as target one ; in both groups the commonest grade of differentiation is the grade two (82%); while adenocarcinoma was the commonest histopathological type (92%).              The primary tumor was resected in (62%) of patients all due to intestinal obstruction. Reassessment of all patients in both groups was done by Lab investigation and radiological assessment, the median progression free survival was 24.7 months.
CONCLUSION:
In our study, the progression with statistical significance was seen among patients with right sided tumor, patients with multiple sites of metastases, those who treated by Chemotherapy only without target therapies, and in patients who had mucinous adenocarcinoma .