Colorectal Cancer in Romania: Surgical Strategies, Survival, and Historical Trends in a 302-Patient Cohort.

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, with Romania reporting among the highest rates in the European Union. Regional outcome data remain scarce. Methods: We performed a retrospective cohort study of 302 patients with surgically treated colorectal adenocarcinoma at a Romanian tertiary hospital between 2003 and 2005, with a median follow-up of 60 months. Survival was analyzed using Kaplan-Meier and Cox regression. Results: Radical resection with R0 margins was achieved in 72% of cases. The overall 5-year survival was 38%, with significantly lower outcomes in advanced stages. Independent predictors of poor prognosis included advanced stage, emergency surgery, incomplete resection, and older age. Conclusions: Survival outcomes in this Romanian cohort were substantially lower than those reported in Western Europe, reflecting the burden of late-stage presentation. These findings emphasize the urgent need for nationwide CRC screening programs and wider access to modern multimodal therapies.