title: Colorectal cancer treated at Christchurch Hospital, New Zealand: a comparison of 1993 and 1998 cohorts.
abstract: 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.
authors.affiliation: 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
authors.forename: Bridget
authors.initials: B
authors.lastname: Robinson
authors.forename: Frank
authors.initials: F
authors.lastname: Frizelle
authors.forename: Michelle
authors.initials: M
authors.lastname: Dickson
authors.forename: Chris
authors.initials: C
authors.lastname: Frampton
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents