In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 4_suppl ( 2012-02-01), p. 589-589
Abstract:
589 Background: The objective of this trend analysis was to assess whether clinical outcomes following rectal cancer resection have improved over a 15-year time period. Methods: The present study is based on the colorectal database of the authors` hospital, one of the largest tertiary care centers of Switzerland. All patients undergoing a rectal cancer resection for stage I - IV disease were consecutively included between 1991 and 2005. The 15-year time period was subdivided into five 3-year periods, among which different outcomes were compared. All tests were two-sided, the level of statistical significance was set at 0.05. Results: Overall, 682 consecutive patients undergoing a rectal cancer resection for stage I - IV disease were included. Mean age was 65 years (range: 24 to 93 years), 62.1% of patients were male, median ASA physical status was 2 (range 1 – 4). Among the various time periods, there were no significant differences regarding patients` demographics as well as tumor stage. All following outcomes significantly decreased over time: operating room time (max. 217minutes to 164 minutes, P-trend: 〈 0.001), rate of abdomino-perineal resections (from 20.5% to 7.6%; P-trend 〈 0.001), rate of R1/2 resections (from 16.9% to 8.6%; P-trend: 0.008), rate of intraoperative complications (from 16.9% to 4.9%; P-trend: 0.018), rate of general postoperative complications (from 59% to 35.1%; P-trend 〈 0.001), and rate of local recurrence (8.4% to 4.9%; P-trend:0.033). 5-year overall survival did not significantly change over time, neither in the overall patient cohort (P-trend: 0.476), nor in the subsets of stage I-III (P-trend: 0.675) and stage IV patients (P-trend: 0.486). Conclusions: This first study in the literature based on a large cohort of consecutive stage I – IV rectal cancer patients provides compelling evidence that that operating room time as well as rates of abdomino-perineal resections, R1/2 resections, intra- and postoperative complications, as well as rates of local recurrence have significantly decreased from 1991 – 2005. However, there was no significant improvement of overall survival, neither in the overall cohort nor in the subsets of stage I-III versus stage IV rectal cancer patients.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.4_suppl.589
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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