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A population-based study of the extent of surgical resection of potentially curable colon cancer

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Abstract

Background

We attempted to determine factors contributing to the extent of initial curative resection for colon cancer in a population-based cohort. Total abdominal colectomy with ileorectal anastomosis (TAC-IR) may be considered for young patients or those with a colorectal cancer family history to prevent metachronous lesions and facilitate surveillance.

Methods

All Ontario patients newly diagnosed with colon cancer over 12 months beginning in July 1997 were staged at the time of surgery. The extent of resection was compared with variables, including familial risk obtained from the Ontario Familial Colon Cancer Registry.

Results

Complete staging was possible for 86% of patients. A total of 1223 patients had a potentially curative resection: 17%, 46%, and 36% were stage I, II, and III, respectively. Patients were more likely to receive a TAC-IR if they were ≤50 years old (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.8–6.6), if they had a synchronous lesion (OR, 28.37; 95% CI, 12.2–61.2), or if they were at a teaching hospital (OR, 2.8; 95% CI, 1.6–4.7), but not if they had a family history (OR, 7; 95% CI, 3–1.5).

Conclusions

Young age, teaching hospital, and multiple cancers but not family history were important factors for performing a TAC-IR.

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Authors and Affiliations

  1. Room 3-130, Department of Surgical Oncology, Princess Margaret Hospital, 610 University Ave., M5G 2M9, Toronto, Ontario, Canada

    Alexandra M. Easson MD & Jacqueline A. Crosby MD

  2. Department of Epidemiology & Statistics, Princess Margaret Hospital, Toronto, Ontario, Canada

    Heather Sutherland MSc

  3. Division of Preventive Oncology, Cancer Care Ontario, Toronto, Ontario, Canada

    Michelle Cotterchio PhD

  4. Surveillance Unit, Cancer Care Ontario, Toronto, Ontario, Canada

    Eric Holowaty MD

  5. Ontario Cancer Registry, Cancer Care Ontario, Toronto, Ontario, Canada

    Darlene Dale CCHR(A)

  6. the Familial GI Cancer Registry, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada

    Melyssa Aronson MSc

  7. Department of Surgery, University of Toronto, Mount Sinai Hospital, Toronto, Ontario, Canada

    Steven Gallinger MD

Authors
  1. Alexandra M. Easson MD
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  2. Michelle Cotterchio PhD
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  3. Jacqueline A. Crosby MD
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  4. Heather Sutherland MSc
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  5. Darlene Dale CCHR(A)
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  6. Melyssa Aronson MSc
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  7. Eric Holowaty MD
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Correspondence to Alexandra M. Easson MD.

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Easson, A.M., Cotterchio, M., Crosby, J.A. et al. A population-based study of the extent of surgical resection of potentially curable colon cancer. Annals of Surgical Oncology 9, 380–387 (2002). https://doi.org/10.1007/BF02573873

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  • DOI: https://doi.org/10.1007/BF02573873

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