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Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades

International Journal of Colorectal Disease volume 30, pages 797–806 (2015)Cite this article

An Erratum to this article was published on 13 February 2016

Abstract

Purpose

This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time.

Methods

This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis.

Results

Five-year CSS rates improved for colonic cancer from 65.0 % for patients treated between 1981 and 1986 to 88.1 % for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4 % in the first observation period to 89.8 % in the second one. The local recurrence rate for rectal cancer dropped from 34.2 % in the years 1981–1986 to 2.1 % in the years 2007–2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7 %, p = 0.409).

Conclusion

Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Affiliations

  1. Department of General and Visceral Surgery, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Dresden, Germany

    Fischer Joern, Hellmich Gunter, Jackisch Thomas, Witzigmann Helmut & Stelzner Sigmar

  2. Institute of Pathology, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Dresden, Germany

    Puffer Erik

  3. Department of Radiation Therapy, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Dresden, Germany

    Zimmer Jörg

  4. Department of Oncology, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Dresden, Germany

    Bleyl Dorothea

  5. Department of Radiology, Dresden-Friedrichstadt General Hospital, Teaching Hospital of the Technical University of Dresden, Dresden, Germany

    Kittner Thomas

  6. Klinik für Allgemein- und Viszeralchirurgie, Krankenhaus Dresden-Friedrichstadt, Friedrichstraße 41, 01067, Dresden, Germany

    Stelzner Sigmar

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  1. Fischer Joern
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Correspondence to Stelzner Sigmar.

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Joern, F., Gunter, H., Thomas, J. et al. Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades. Int J Colorectal Dis 30, 797–806 (2015). https://doi.org/10.1007/s00384-015-2219-5

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Keywords

  • Rectal and colon cancer
  • Treatment improvement
  • Three decades