title: [Rectal cancer surgery in Germany - a 10-year-analysis based on the data of the "Institute of Quality Assurance in Operative Medicine" at the Otto-von-Guericke University Magdeburg].
abstract: BACKGROUND
  The treatment of rectal cancer has undergone pronounced changes during the last two decades. There has been a significant improvement in local tumour control due to consequent use of neo-adjuvant therapy and total mesorectal excision in cases of distal rectal cancer. The presented analysis examines the realisation of the multimodal therapy for rectal cancer under the conditions of routine patient-centred care over a period of ten years.
  
  
  METHODS
  The data acquired in the prospective multicentre observational study "Quality Assurance - Rectal Cancer" from the years 2000 to 2010 were analysed. N = 33,724 patients were documented. The resection rate was 95.2 %. The rate of curative resection was 84.2 %.
  
  
  RESULTS
  No change was detected in perioperative total morbidity and lethality during the course of the study. The percentage of patients with neo-adjuvant treatment and curative resection rose from 5.6 % (2000) to 40.5 % (2012). The rate of performed TME in distal rectal cancer rose from 75.2 % (2000) to 95.3 % (2012). For patients who underwent curative resection in the years 2000/2001 the 5-year local recurrence rate was 11.7 %, while it was found to be 4.6 % for patients who were thus treated in the years 2005/2006 (p < 0.001). There was no improvement of total survival.
  
  
  CONCLUSIONS
  While an increase in the use of neo-adjuvant treatment for rectal cancer and the establishment of TME in routine patient-centred care have led to a significant improvement in local tumour control with a constant total morbidity and lethality, there is no detectable influence on the patients' total survival.
authors.affiliation: AN-Institut für Qualitätssicherung in der operativen Medizin an der O-v-G-Universität Magdeburg, Magdeburg, Deutschland. henryptok@aol.com
authors.forename: H
authors.initials: H
authors.lastname: Ptok
authors.forename: A
authors.initials: A
authors.lastname: Mundt
authors.forename: H
authors.initials: H
authors.lastname: Lippert
authors.forename: I
authors.initials: I
authors.lastname: Gastinger
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011785:Quality Assurance, Health Care; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies