title: Management of rectal cancer in France in a well-defined population.
abstract: OBJECTIVE
  The aim of this study was to draw a picture of diagnostic assessment and patterns of care for rectal cancer in France using population-based registries data.
  
  
  METHODS
  The study included a random sample of 669 cases of rectal cancers diagnosed in 2005.
  
  
  RESULTS
  Diagnostic assessment was performed by colonoscopy in 91.4% of the cases. An abdominal computed tomography was performed in 59.4% of the cases and chest computed tomography in 47.8%. An R0 resection was performed in 65.8% of cases and an R1/R2 resection in 16.1%. A rectal endosocography was performed in 40.4% and MRI in 10.4%. The sphincter was preserved in 73.6% of patients aged younger than 75 years of age and in 62.5% of those older than 75 years of age (P=0.002). In cases of R0 resection, neoadjuvant radiotherapy was performed in 47.8% of patients younger than 75 years of age and in 34.1% of older patients (P=0.007). Postoperative chemotherapy was administered in 23.9% of stage II and 67.8% of stage III resected patients.
  
  
  CONCLUSIONS
  The management of rectal cancers can be improved. Preoperative staging has not reached its full development; very few patients received neoadjuvant treatment, whereas adjuvant chemotherapy was often performed, although its benefit is still unclear. The management of elderly patients was less optimal than that of younger patients.
authors.affiliation: aBurgundy Digestive Cancer Registry, INSERM U866; University of Burgundy; University Hospital Dijon, Dijon bFRANCIM (French Network of Cancer Registries), Toulouse, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Desgrippes
authors.forename: Véronique
authors.initials: V
authors.lastname: Bouvier
authors.forename: Patricia
authors.initials: P
authors.lastname: Delafosse
authors.forename: Michel
authors.initials: M
authors.lastname: Robaszkiewicz
authors.forename: Florence
authors.initials: F
authors.lastname: Molinié
authors.forename: Brigitte
authors.initials: B
authors.lastname: Trétarre
authors.forename: Côme
authors.initials: C
authors.lastname: Lepage
authors.forename: Jean
authors.initials: J
authors.lastname: Faivre
authors.forename: Valérie
authors.initials: V
authors.lastname: Jooste
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
mesh_terms: D000367:Age Factors; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D003113:Colonoscopy; D005602:France; D006801:Humans; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D012042:Registries; D014057:Tomography, X-Ray Computed