title: Assessment of management practices for colonic cancer in the Paris metropolitan area in 2002.
abstract: OBJECTIVE
  To assess the management of patients aged 18 years or older with colonic adenocarcinoma (including the rectosigmoid junction), compared with French guidelines (ANAES and SOR).
  
  
  METHODS
  This retrospective study carried out in 2003 by the Ile-de-France regional union of health insurance funds from hospital discharge and operative and pathology reports of patients exempted from copayment between April 2001 and March 2002.
  
  
  RESULTS
  In all, 1 842 patients were included; mean age was 68.7 +/- 12.7 years and the M/F ratio was 1.09. 17.3% of patients were diagnosed after complications (obstruction, perforation); 25.1% had synchronous metastases, 79.7% with at least one liver metastasis. Serum CEA assay was performed in 50.0% of patients, in combination with CA 19-9 in 31.1% of patients. In 24.9%, less than 8 lymph nodes were analyzed. 37.7% of stage II patients had chemotherapy while 10.8% of stage III and 9.8% of stage IV patients did not. Age was a determining factor in the decision of chemotherapy (P<0.0001).
  
  
  CONCLUSIONS
  Implementation of guidelines for the management of colon cancer can be improved, notably regarding pathologic analysis and indications of chemotherapy.
authors.affiliation: Direction Régionale du Service Médical de l'Assurance Maladie d'Ile-de-France, Paris. lina.silvera@cnamts.fr
authors.forename: Lina
authors.initials: L
authors.lastname: Silvéra
authors.forename: Gilles
authors.initials: G
authors.lastname: Galula
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Tiret
authors.forename: Christophe
authors.initials: C
authors.lastname: Louvet
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Leroux
authors.forename: Bernard
authors.initials: B
authors.lastname: Trutt
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000473:pathology; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003625:Data Collection; D003627:Data Interpretation, Statistical; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000628:therapy; D010297:Paris; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires