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. 1999 Mar;44(3):377–381. doi: 10.1136/gut.44.3.377

Evidence of improving survival of patients with rectal cancer in France: a population based study

C Finn-Faivre 1, J Maurel 1, A Benhamiche 1, C Herbert 1, E Mitry 1, G Launoy 1, J Faivre 1
PMCID: PMC1727407  PMID: 10026324

Abstract

BACKGROUND—Over the past 20 years there have been many changes in the management of rectal cancer. Their impact on the overall population is not well known. 
AIMS—To determine trends in management and prognosis of rectal cancer in two French regions. 
SUBJECTS—1978 patients with a rectal carcinoma diagnosed between 1978 and 1993. 
METHODS—Time trends in treatment, stage at diagnosis, operative mortality, and survival were studied on a four year basis. A non-conditional logistic regression was performed to obtain an odds ratio for each period adjusted for the other variables. To estimate the independent effect of the period a multivariate relative survival analysis was performed. 
RESULTS—Over the 16 year period resection rates increased from 66.0% to 80.1%; the increase was particularly noticeable for sphincter saving procedures (+30.6% per four years, p=0.03). The percentage of patients receiving adjuvant radiotherapy increased from 24.0% to 40.0% (p=0.02). The proportion of patients with Dukes' type A cancer increased from 17.7% to 30.6% with a corresponding decrease in those with more advanced disease. Operative mortality decreased by 31.1% per four years (p=0.03). All these improvements have resulted in a dramatic increase in relative survival (from 35.4% for the 1978-1981 period to 57.0% for the 1985-1989 period). 
CONCLUSIONS—Substantial advances in the management of rectal cancer have been achieved, but there is evidence that further improvements can be made in order to increase survival. 



Keywords: rectal cancer; treatment; stage at diagnosis; survival; time trends; cancer registries

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Figure 1 .

Figure 1

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Location of the two regions involved in the study. 


Figure 2 .

Figure 2

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Time trends in the stage of tumours at time of diagnosis. 


Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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