title: Evaluation of the management of rectal cancers before and after the consensus conference in France.
abstract: OBJECTIVE
  Population-based registries are the best way to draw a picture of the management of a disease. The purpose of this study was to analyse therapeutic modalities for rectal cancers in seven French areas in 1990 and 1995, before and just after a consensus conference devoted to this topic.
  
  
  METHODS
  A community-based series of 945 patients (402 in 1990, 543 in 1995) with rectal cancer was used to assess therapeutic modalities and stage at diagnosis.
  
  
  RESULTS
  Colonoscopy was performed in most of the cases (90% in 1990 and 1995). There was significant change between 1990 and 1995 in stage at diagnosis and cancer resection. The rate of continence-preserving operations was similar in 1990 and in 1995, as was the rate of adjuvant radiotherapy. There was a shift between 1990 and 1995 from postoperative radiotherapy to preoperative radiotherapy. There was an increase in the use of adjuvant chemotherapy.
  
  
  CONCLUSIONS
  Changes in the management of rectal cancer in France over the past few years have concerned mainly resection rate, stage at diagnosis and adjuvant therapy. The recommendations of the consensus conference were followed only partly, in particular for adjuvant preoperative radiotherapy, which has not reached its full development, and adjuvant chemotherapy, which tends to be overprescribed, considering how little is known about its effectiveness.
authors.affiliation: Côte-d'Or and Saône-et-Loire Cancer Registry, Dijon, France. jmphelip@chu-grenoble.fr
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Phelip
authors.forename: Chantal
authors.initials: C
authors.lastname: Milan
authors.forename: Catherine
authors.initials: C
authors.lastname: Herbert
authors.forename: Pascale
authors.initials: P
authors.lastname: Grosclaude
authors.forename: Patrick
authors.initials: P
authors.lastname: Arveux
authors.forename: Nicole
authors.initials: N
authors.lastname: Raverdy
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Daures
authors.forename: Jean
authors.initials: J
authors.lastname: Faivre
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003113:Colonoscopy; D003245:Consensus Statements as Topic; D005260:Female; D005602:France; D006801:Humans; D016015:Logistic Models; D008297:Male; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D012042:Registries; D016896:Treatment Outcome