title: Colorectal carcinoma: analysis of management in two medical eras.
abstract: Trends in presentation, diagnosis, management, and outcome were analyzed for 503 patients with colorectal cancer seen at the UCLA Medical Center between 1960 and 1970 (Group A; n = 210) and 1980 and 1985 (Group B; n = 293). Patients in the latter group exhibited a shift in site to the right side of the colon (18% in Group A vs. 31% in Group B; P < .01), an increase in the number of primary resections without colostomy (38% vs. 61%; P < .01), a lower overall complication rate (28% vs. 18%; P = .01), and a decline in 30-day mortality (6.2% vs. 2%; P = .01). Although little difference was seen in detection of asymptomatic tumors, earlier lesions were treated in the latter group, accounting for substantially reduced rate of recurrence (69% in Group A vs. 44% in Group B; P < .01). Future management should include an emphasis on earlier detection in order to continue the trend toward enhanced survival.
authors.affiliation: Department of Surgery, UCLA School of Medicine.
authors.forename: H K
authors.initials: HK
authors.lastname: Nazarian
authors.forename: A E
authors.initials: AE
authors.lastname: Giuliano
authors.forename: J R
authors.initials: JR
authors.lastname: Hiatt
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D003125:Colostomy / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011183:Postoperative Complications / Q000401:mortality; D013997:Time Factors