title: Changes in the management and outcome of rectal cancer over a 10-year period in Oxford.
abstract: OBJECTIVE
  The changes in the management and outcome of rectal cancer in Oxford were studied over a 10-year period.
  
  
  METHODS
  Rectal cancer data using a prospectively collected data base were divided into curative (global) and palliative groups. The global curative group was further divided into those with and without (selected group) the following features: emergency cases, local excision, salvage surgery for recurrence or incomplete local excision, metastatic disease, perioperative death, hereditary cancer, inflammatory bowel disease-related cancer, and synchronous cancer.
  
  
  RESULTS
  Between 1994 and 2003, 709 cases of rectal cancer were treated, 532 for cure and a selected group of 393 after removing patients with the aforementioned exclusions. For the selected group, the average follow-up was 51.2 months, overall survival 65.4% and cancer-specific survival 75.3%. There was no 2-year survival difference between each of the 10-year periods of study. Two-year local recurrence was 5.6% for the first 5-year period and 2.3% for the second (P = 0.11). MRI staging increased during the 10 years (0% in 1994; 66.7% in 2003) as did use of definitive chemoradiotherapy (dCRT) (0% in 1994; 64.7% in 2003). The anastomotic leakage rate was significantly higher in the second 5-year period (2.6%vs 9.6%; P = 0.01).
  
  
  CONCLUSIONS
  Despite increasing use of MRI and dCRT, 2-year survival and local recurrence were not significantly different within the 10 years studied.
authors.affiliation: Department of Colorectal Surgery, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.
authors.forename: W
authors.initials: W
authors.lastname: Chambers
authors.forename: L
authors.initials: L
authors.lastname: Hancock
authors.forename: R
authors.initials: R
authors.lastname: McKenzie
authors.forename: O
authors.initials: O
authors.lastname: Buchel
authors.forename: I
authors.initials: I
authors.lastname: Lindsey
authors.forename: C
authors.initials: C
authors.lastname: Cunningham
authors.forename: B
authors.initials: B
authors.lastname: George
authors.forename: N
authors.initials: N
authors.lastname: Mortensen
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology; D059248:Chemoradiotherapy / Q000639:trends*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000639:trends*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D010166:Palliative Care / Q000639:trends*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D006113:United Kingdom