Changes in the management and outcome of rectal cancer over a 10-year period in Oxford.
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.
Chambers
W
W
Department of Colorectal Surgery, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.
Hancock
L
L
McKenzie
R
R
Buchel
O
O
Lindsey
I
I
Cunningham
C
C
George
B
B
Mortensen
N
N
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