A 10-year prospective audit of outcome of surgical treatment for colorectal carcinoma.
The outcome of 555 patients who underwent surgery under the care of a surgeon with an interest in colorectal disease was examined prospectively over a 10-year period with no exclusions. There was a 4.7 percent incidence of clinical leaks (10 percent for anterior resection) and an overall corrected 10-year survival rate after curative surgery of 58, 59 and 48 percent for right colonic, left colonic and rectal tumours respectively. The incidence of isolated local recurrence was 8 percent after curative surgery for carcinoma of the rectum. Twenty-five percent of patients with rectal tumours required abdominoperineal excision. Patients who underwent curative abdominoperineal excision of the rectum had corrected 5- and 10-year survival rates of 48 and 36 percent, compared with 60 and 58 percent respectively for curative anterior resection. The perioperative mortality rate of those undergoing palliative surgery was 8 percent, and 75 percent died within 2 years from distant and not local disease. A policy of always attempting resection was validated by the fact that 99 percent of primary tumours were removed with a low perioperative mortality rate (4 percent overall), a high curative resection rate and a low morbidity rate.
Department of Surgical Gastroenterology, Royal Surrey County Hospital, Guildford, UK.
S
S
Singh
M B
MB
Morgan
M
M
Broughton
S
S
Caffarey
C
C
Topham
C G
CG
Marks
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010166:Palliative Care; D011183:Postoperative Complications; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome