Changes in outcome following surgery for colorectal cancer: one surgeon’s experience
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Colorectal cancer (CRC) has the second highest mortality rate of all cancers in Ireland. Developments in imaging, surgical technique, and perioperative care in the last two decades have altered management.
To determine whether outcome following surgery for CRC in the mid-west has changed over a 22-year period.
Four hundred and twenty-two patients were divided into two time periods: Group A (1980–1991, n = 203) and Group B (1992–2002, n = 219) and demographic, inpatient, and survival data were reviewed.
The mean age was 67 years, 59% were male. Group B patients had less advanced disease at presentation (Dukes’ stage D 14% vs 22%,p<0.05), fewer perioperative complications (13% vs 23%,p<0.05), and fewer local recurrences (6.8% vs n.8%,p<0.05) than Group A. No difference in 30-day mortality rate or survival was detected.
Although perioperative CRC management has improved, methods of earlier diagnosis and improvements in adjuvant therapy should be explored to improve survival.
- The National Cancer Registry in Ireland. Incidence, Mortality, Treatment and Survival. Annual Report 1997.
- Campo J, Comber H, Gavin AT. All-Ireland Cancer Statistics 1998–2000. Northern Ireland Cancer Registry/ National Cancer Registry 2004.
- The National Cancer Registry in Ireland. Cancer in Ireland 1994–2002. Incidence, Mortality, Treatment and Survival.
- NicAmhlaoibh, R, Mahmud, S, Comber, H (2004) Patterns in care and survival from cancer in Ireland 1994–1998. National Cancer Registry, Ireland
- Mandel, JS, Bond, JH, Church, TR (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 328: pp. 1365-1371 CrossRef
- Selby, JV, Friedman, GD, Quesenberry, CP, Weiss, NS (1993) Effect of fecal occult blood testing on mortality from colorectal cancer: a case-control study. Ann Intern Med 118: pp. 1-6
- Winawer, SJ, Zauber, AG, Ho, MN (1993) Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329: pp. 1977-1981 CrossRef
- Winawer, SJ, Zauber, AG, O’Brien, MJ (1993) Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. N Engl J Med 328: pp. 901-906 CrossRef
- Levin, B, Murphy, GP (1992) Revision in American Cancer Society recommendations for the early detection of colorectal cancer. CA Cancer J Clin 42: pp. 296-299 CrossRef
- Colorectal Cancer Management Clinical Guidelines. The Clinical Guidelines Committee, Royal College of Surgeons in Ireland, November 2002.
- Dowdall, JF, Maguire, D, McAnena, OJ (2002) Experience of surgery for rectal cancer with total mesorectal excision in a general surgical practice. Br J Surg 89: pp. 1014-9 CrossRef
- Kirwan, WO, O’Riordain, MG, Waldron, R (1989) Declining indications for abdominoperineal resection. Br J Surg 76: pp. 1061-3 CrossRef
- McCallion, K, Mitchell, RM, Wilson, RH (2001) Flexible sigmoidoscopy and the changing distribution of colorectal cancer: implications for screening. Cut 48: pp. 522-5
- Karanjia, ND, Cored, AP, Bearn, P, Heald, RJ (1994) Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 81: pp. 1224-6 CrossRef
- Rullier, E, Laurent, C, Garrelon, JL (1998) Risk factors for anastomotic leakage after anterior resection of rectal cancer. Br J Surg 85: pp. 355-8 CrossRef
- Memon, AA, Marks, CG (1996) Stapled anastomoses in colorectal surgery: a prospective study. Eur J Surg 162: pp. 805-10
- Miller, K, Moritz, E (1996) Circular stapling techniques for low anterior resection of rectal carcinoma. Hepatogastroenterology 43: pp. 823-31
- Heald, RJ, Moran, BJ, Ryall, RDH (1998) Rectal cancer — The Basingstoke experience of total mesorectal excision 1978–1997. Arch Surg 133: pp. 894-899 CrossRef
- Scott, N, Jackson, P, Al Jaberi, T (1995) Total mesorectal excision and local recurrence: a study of tumour spread in the mesorectum distal to rectal cancer. Br J Surg 82: pp. 1031-3 CrossRef
- Carlsen, E, Schlichting, E, Guldov, I (1998) Effect of the introduction of total mesorectal excision for the treatment of rectal cancer. Br J Surg 85: pp. 526-9 CrossRef
- Heald, RJ, Karanjia, ND (1992) Results of radical surgery for rectal cancer. World J Surg 16: pp. 848-57 CrossRef
- Tekkis, PP, Poloniecki, JD, Thompson, MR, Stamatakis, JD (2003) Operative mortality in colorectal cancer: prospective national study. BMJ 327: pp. 1196-201 CrossRef
- Howe, HL, Wingo, PA, Thun, MJ (2001) Annual report to the nation on the status of cancer, 1973 through 1998, featuring cancers with increasing trends. J Natl Cancer Inst 93: pp. 824-842 CrossRef
- Weir, HK, Thun, MJ, Hankey, BF (2003) Annual report to the nation on the status of cancer, 1975–2000, featuring the uses of surveillance data for cancer prevention and control. J Natl Cancer Inst 95: pp. 1276-1299
- Mandel, J, Church, TR, Ederer, F (1999) Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst 91: pp. 434-434 CrossRef
- Changes in outcome following surgery for colorectal cancer: one surgeon’s experience
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