Chronological improvement in survival following rectal cancer surgery: a large-scale, single-center study.

Abstract:

BACKGROUND:Total mesorectal excision (TME) and preoperative chemoradiation therapy (PCRT) for rectal cancer are used sequentially in our center. The aim of this study was to evaluate survival of patients with stage II/III rectal cancer chronologically and to determine whether therapeutic advances associated with TME and PCRT have improved patient survival. METHODS:A retrospective review of 2,197 patients from July 1989 to December 2006 was conducted. The time period (P) for this study was divided into three groups: P1 (1989-1995), P2 (1996-2001) for TME, P3 (2002-2006) for PCRT. Cancer-specific survival (CSS), disease-free survival (DFS), and recurrences among the three periods were investigated. RESULTS:A total of 293 patients in P1, 836 patients in P2, and 1,068 patients in P3 were enrolled. The 5-year CSS in stages II and III was statistically different between P1/P2 and P3 (stage II, p = 0.008; stage III, p < 0.001). The 5-year DFS was significantly different between P1/P2 and P3 for stage III (p = 0.001). The local recurrence and systemic recurrence rates decreased during P3, but there was no significant difference between the three periods for stage II. For stage III, local recurrence was significantly different between the three periods (P1 vs. P2, p = 0.002; P1 vs. P3, p < 0.001; P2 vs. P3, p = 0.008). CONCLUSIONS:We identified an improvement in survival for stage II/III rectal cancer and a decrease in local recurrence for stage III rectal cancer during P3, the most recent period. This may be due to frequent application of PCRT based on the TME.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Lee JL,Yu CS,Kim CW,Yoon YS,Lim SB,Kim JC

doi

10.1007/s00268-013-2168-5

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

2693-9

issue

11

eissn

0364-2313

issn

1432-2323

journal_volume

37

pub_type

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