Colorectal carcinoma: analysis of management in two medical eras

J Surg Oncol. 1993 Jan;52(1):46-9. doi: 10.1002/jso.2930520113.

Abstract

Trends in presentation, diagnosis, management, and outcome were analyzed for 503 patients with colorectal cancer seen at the UCLA Medical Center between 1960 and 1970 (Group A; n = 210) and 1980 and 1985 (Group B; n = 293). Patients in the latter group exhibited a shift in site to the right side of the colon (18% in Group A vs. 31% in Group B; P < .01), an increase in the number of primary resections without colostomy (38% vs. 61%; P < .01), a lower overall complication rate (28% vs. 18%; P = .01), and a decline in 30-day mortality (6.2% vs. 2%; P = .01). Although little difference was seen in detection of asymptomatic tumors, earlier lesions were treated in the latter group, accounting for substantially reduced rate of recurrence (69% in Group A vs. 44% in Group B; P < .01). Future management should include an emphasis on earlier detection in order to continue the trend toward enhanced survival.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anastomosis, Surgical
  • Chi-Square Distribution
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / surgery*
  • Colostomy / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Los Angeles / epidemiology
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Postoperative Complications / mortality
  • Time Factors