A population-based study of the extent of surgical resection of potentially curable colon cancer.
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 < or = 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.
Easson
Alexandra M
AM
Department of Surgical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada. easson.alexandra@uhn.on.ca
Cotterchio
Michelle
M
Crosby
Jacqueline A
JA
Sutherland
Heather
H
Dale
Darlene
D
Aronson
Melyssa
M
Holowaty
Eric
E
Gallinger
Steven
S
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009864:Ontario / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome