Changes in the management and outcome of rectal cancer over a 10-year period in Oxford

Colorectal Dis. 2011 Sep;13(9):1004-8. doi: 10.1111/j.1463-1318.2010.02360.x. Epub 2010 Jul 1.

Abstract

Aim: The changes in the management and outcome of rectal cancer in Oxford were studied over a 10-year period.

Method: Rectal cancer data using a prospectively collected data base were divided into curative (global) and palliative groups. The global curative group was further divided into those with and without (selected group) the following features: emergency cases, local excision, salvage surgery for recurrence or incomplete local excision, metastatic disease, perioperative death, hereditary cancer, inflammatory bowel disease-related cancer, and synchronous cancer.

Results: Between 1994 and 2003, 709 cases of rectal cancer were treated, 532 for cure and a selected group of 393 after removing patients with the aforementioned exclusions. For the selected group, the average follow-up was 51.2 months, overall survival 65.4% and cancer-specific survival 75.3%. There was no 2-year survival difference between each of the 10-year periods of study. Two-year local recurrence was 5.6% for the first 5-year period and 2.3% for the second (P = 0.11). MRI staging increased during the 10 years (0% in 1994; 66.7% in 2003) as did use of definitive chemoradiotherapy (dCRT) (0% in 1994; 64.7% in 2003). The anastomotic leakage rate was significantly higher in the second 5-year period (2.6%vs 9.6%; P = 0.01).

Conclusion: Despite increasing use of MRI and dCRT, 2-year survival and local recurrence were not significantly different within the 10 years studied.

MeSH terms

  • Anastomotic Leak / etiology
  • Chemoradiotherapy / trends*
  • Humans
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging / trends*
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Staging
  • Palliative Care / trends*
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / therapy*
  • Treatment Outcome
  • United Kingdom