title: Adenocarcinoma of the colon and rectum: a report on 624 cases.
abstract: A total of 624 patients with adenocarcinoma of the large bowel and operated between 1958 and 1978 were retrospectively studied. According to the period of operation, patients were divided into group A (1958 to 1968, n = 259) and group B (1969 to 1978, n = 365). Symptoms were closely related to tumour location. Blood loss and change in bowel habits were most frequent in patients with left-sided cancer, while anaemia, loss of body weight and abdominal pain turned out to be the predominant symptoms in patients with right-sided cancer. Patients with cancer of the transverse colon or splenic flexure showed a high incidence of ileus (19%). Resection of the primary tumour was possible in 86% of the cases. The overall morbidity was 48% and the postoperative mortality was 8%. Anastomotic dehiscence occurred in 4% of our patients. There was no significant difference in postoperative mortality between the two patient groups. The mortality is closely related to the Dukes stage (Dukes A 4%, Dukes D 19%). The overall crude survival was 45%, the corrected survival 57%. Patients with cancer of the descending colon or (recto)sigmoid had a higher corrected 5-year survival when compared to patients with cancers in other tumour sites (65% versus 52%, p less than 0.01). Dukes stage, ileus as primary symptom were also correlated with survival, while sex distribution, age and duration of symptoms were not.
authors.affiliation: Department of Surgery, University Hospital Leiden, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Bloem
authors.forename: A
authors.initials: A
authors.lastname: Zwaveling
authors.forename: T
authors.initials: T
authors.lastname: Stijnen
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D012189:Retrospective Studies