Recurrence Rates and Postoperative Complications Following Colorectal Cancer Surgery: A 5-Year Study at a Tertiary Care Hospital in Peshawar

Colorectal Cancer (CRC) is a leading cause of cancer related morbidity and mortality in the world. In low- and middle-income countries like Pakistan, delayed diagnosis, lack of access to specialist care, and irregular post-operative surveillance make things worse for a successful outcome. Objective: To evaluate the five-year recurrence rates and postoperative complications among patients undergoing colorectal cancer surgery at a tertiary care center in Peshawar, KPK, Pakistan. Methods: This retrospective cohort study was carried out in the department of General Surgery, Hayatabad Medical Complex, Peshawar, from March 2020 to February 2025. Patients presenting with metastatic disease at the time of surgery, palliative or bypass procedures, patients with missing follow-up data and patients lost to follow-up within 12 month following surgery were excluded from the study. Results: In terms of tumor stage, 14.4% had stage I, 28.5% had stage II, 46.8% had stage III, and 10.3% had stage IV. The majority of the patients (61.5%) underwent open surgery, while 38.5% underwent laparoscopic surgery. Postoperative complications were recorded in 122(39.1%) patients. Anastomotic leakage occurred in 6.7%, while surgical site infections (SSI) were observed in 12.2% of cases. Conclusions: A 26.9% recurrence rate and a high burden of postoperative complications were observed among colorectal cancer patients. Advanced stage, open surgery, anastomotic leaks, and older age were significantly associated with increased recurrence risk.