Colorectal cancer treated at Christchurch Hospital, New Zealand: a comparison of 1993 and 1998 cohorts.
OBJECTIVE
To compare clinicopathological variables, management, and outcome of two cohorts of unselected patients treated for colorectal cancer (CRC) at Christchurch Hospital, New Zealand in 1993-94 and 1998-99.


METHODS
Retrospective review from hospital discharge codes, oncology referral database, and histology database. Data was stored in a Microsoft Access database.


RESULTS
356 patients in 1993-94 and 317 patients in 1998-99 had a confirmed diagnosis of adenocarcinoma of the colon or rectum. At the minimum follow-up time of 42 months, 54% (40% of CRC) of the 356 patients in the first cohort, and 36% (26% of CRC) of the 317 patients in the second cohort had died. The Kaplan-Meier survival curves showed significant improvement in 1998-99 overall, as well as for Dukes stages A plus B, stage C, and stage D disease. Computed tomography (CT) scan-staging increased from 11.3% to 62.8%. On multivariate analysis, cohort, stage, vascular/lymphatic invasion, and elective surgery were independent prognostic factors for disease-specific mortality. Over the 5 years (1993-94 to 1998-99), surgery by consultant increased from 44% to 82%, adjuvant chemotherapy for Dukes stage C increased from 21% to 45%, and chemotherapy for metastatic disease increased from 2.4% to 23% of stage D and from 2.5% to 36.5% of those patients who developed metastases.


CONCLUSIONS
The improvement in outcome is attributed to more specialised surgery, more frequent CT scan staging, and greater use of chemotherapy.
Robinson
Bridget
B
Department of Oncology, Canterbury District Health Board, Christchurch Hospital and the Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand. BridgetR@cdhb.govt.nz
Frizelle
Frank
F
Dickson
Michelle
M
Frampton
Chris
C
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D015988:Cohort Effect; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D006801:Humans; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000970:Antineoplastic Agents