Improved perioperative care is associated with improved long-term survival in colorectal cancer
- 183 Downloads
To compare perioperative colorectal cancer care and survival in patient cohorts operated in 2005 and in 2010 in Lithuania.
Comparative observational cohort study was performed. The study was conducted in the three Lithuanian cancer hospitals. Patients, who underwent curative surgery for colorectal cancer in 2005 and 2010, were included. Demographic characteristics, distribution of the tumors, preoperative diagnostics and staging, surgical treatment, the quality of pathological examination, morbidity, and mortality were analyzed. One- and 5-year overall survival data were compared between the groups.
Colorectal cancer diagnostics and treatment improved from 2005 to 2010 significantly. The disease was identified as stage III–IV for 45 vs. 48% of the patients; however, computed tomography staging scan was performed only for 5.9 vs. 17.8% in 2005 and 2010, respectively. Laparoscopic operations were performed 1.5 vs. 10.5% and abdominoperineal resections—42.7 vs. 31.7% in 2005 and 2010, respectively. The number of harvested lymph nodes was mentioned in 55.8 vs. 97.7% of the cases, whereas more than 12 lymph nodes were examined in 18 vs. 66.6% of cases after histological examination. The overall 5-year survival was 52.1 vs. 63.1% (p < 0.0001), while the 5-year survival of the patients with stage IV of disease was 4.2 vs. 17.8% in 2005 and 2010, respectively.
Preoperative investigation, surgical treatment, pathological examination, and postoperative course are associated with improved overall survival in colorectal cancer patients, undergoing curative surgery in the resource-limited settings.
KeywordsColon cancer Rectal cancer Carcinoma Survival Surgical treatment Perioperative Care Complications Survival
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 3.Poškus E, Mikalauskas S, Jotautas V, Žeromskas P, Poškus T, Strupas K, Samalavičius NE, Lasinskas M, Sklepavičius A, Tamelis A, Saladžinskas Ž, Pavalkis D, Jakaitienė A, Smailytė G (2013) The pattern of colorectal cancer surgery in Lithuania in 2005: do results meet expectations? Medicina 49(3):124–131PubMedGoogle Scholar
- 6.Bülow S, Harling H, Iversen LH, Ladelund S, Danish Colorectal Cancer Group (2010) Improved survival after rectal cancer in Denmark. Color Dis 12(7 Online):e37–e42Google Scholar
- 9.Guren MG, Kørner H, Pfeffer F, Myklebust TÅ, Eriksen MT, Edna TH, Larsen SG, Knudsen KO, Nesbakken A, Wasmuth HH, Vonen B, Hofsli E, Færden AE, Brændengen M, Dahl O, Steigen SE, Johansen MJ, Lindsetmo RO, Drolsum A, Tollåli G, Dørum LM, Møller B, Wibe A (2015) Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993–2010. Acta Oncol 54(10):1714–1722CrossRefPubMedGoogle Scholar
- 12.Maurer CA, Dietrich D, Schilling MK, Metzger U, Laffer U, Buchmann P, Lerf B, Villiger P, Melcher G, Klaiber C, Bilat C, Brauchli P, Terracciano L, Kessler K (2017) Prospective multicenter registration study of colorectal cancer: significant variations in radicality and oncosurgical quality—Swiss Group for Clinical Cancer Research Protocol SAKK 40/00. Int J Color Dis 32(1):57–74CrossRefGoogle Scholar
- 21.Martínez-Pérez A, Carra MC, Brunetti F, de'Angelis N (2017) Pathologic outcomes of laparoscopic vs open mesorectal excision for rectal cancer: a systematic review and meta-analysis. JAMA Surg 152(4):e165665. https://doi.org/10.1001/jamasurg.2016.5665
- 22.Vennix S, Pelzers L, Bouvy N, Beets GL, Pierie JP, Wiggers T, Breukink S (2014) Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev (4):CD005200. https://doi.org/10.1002/14651858.CD005200.pub3
- 23.Benz S, Barlag H, Gerken M, Fürst A, Klinkhammer-Schalke M (2017) Laparoscopic surgery in patients with colon cancer: a population-based analysis. Surg Endosc 31(6):2586–2595. https://doi.org/10.1007/s00464-016-5266-2
- 26.Nagtegaal ID, van de Velde CJH, van der Worp E, Kapiteijn E, Quirke P, van Krieken JHJM, the Pathology Review Committee for the Cooperative Clinical Investigators of the Dutch Colorectal Cancer Group (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol 20(7):1729–1734CrossRefPubMedGoogle Scholar