Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti

S Bülow, F A Moesgaard, P O Crone, P Gandrup, J Holm, O Kronborg, H Hemmert-Lund, T Myrhøj, R H Petersen, N Qvist, H H Raskov, H Thomsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

INTRODUCTION:
The aim of the study was to evaluate the incidence of recurrence of local cancer, distant metastases and survival after conventional low anterior resection for cure in patients with rectal carcinoma, on the basis of the poor prognosis after colorectal cancer in Denmark.
MATERIAL AND METHODS:
Consecutive patients operated on in the nine Danish departments of surgical gastroenterology in 1992-1993. Retrospective collection of data on recurrence of local cancer, distant metastases, and over-all survival at the end of 1996.
RESULTS:
Of 268 patients, 77 (29%) developed recurrent local cancer and/or distant metastases. Forty-eight (18%) had local recurrence with a cumulative 5-year rate of 39%. Distant metastases were seen in 54 (20%). The local recurrence rate increased with increasing Dukes' tumour stage and was higher after operation by a non-specialist (30%) than by a consultant, another specialist, or a surgeon under training and supervised by a consultant (15-17%) (p = 0.04). Multiple regression showed that the recurrence rate was independent of tumour localisation, blood loss, transfusion, anastomotic leakage, and status of the surgeon. The cumulative crude 5-year survival was 50% and independent of the status of the surgeon.
DISCUSSION:
Our relatively high local recurrence rate and the results in the literature after total mesorectal excision (TME) indicate that the conventional technique should be replaced by TME, which has become the recommended method in recent years. Furthermore, we propose a changed strategy in the treatment of rectal cancer. The patients should be treated in fewer departments with established teams of rectal cancer specialists taking part in all operations for rectal cancer.
OriginalsprogDansk
TidsskriftUgeskrift for Laeger
Vol/bind163
Udgave nummer27
Sider (fra-til)3793-7
Antal sider5
ISSN0041-5782
StatusUdgivet - 2. jul. 2001

Fingeraftryk

Rectal Neoplasms
Neoplasms
Consultants
Anastomotic Leak
Gastroenterology
Denmark
Colorectal Neoplasms
Incidence
Surgeons

Emneord

  • Adenocarcinoma
  • Adult
  • Aged
  • Denmark
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Rectal Neoplasms
  • Retrospective Studies
  • Survival Rate

Citer dette

Bülow, S., Moesgaard, F. A., Crone, P. O., Gandrup, P., Holm, J., Kronborg, O., ... Thomsen, H. (2001). Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti. Ugeskrift for Laeger, 163(27), 3793-7.
Bülow, S ; Moesgaard, F A ; Crone, P O ; Gandrup, P ; Holm, J ; Kronborg, O ; Hemmert-Lund, H ; Myrhøj, T ; Petersen, R H ; Qvist, N ; Raskov, H H ; Thomsen, H. / Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti. I: Ugeskrift for Laeger. 2001 ; Bind 163, Nr. 27. s. 3793-7.
@article{37cdb3a580e0453c9fcf5d952a0524d0,
title = "Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti",
abstract = "INTRODUCTION:The aim of the study was to evaluate the incidence of recurrence of local cancer, distant metastases and survival after conventional low anterior resection for cure in patients with rectal carcinoma, on the basis of the poor prognosis after colorectal cancer in Denmark.MATERIAL AND METHODS:Consecutive patients operated on in the nine Danish departments of surgical gastroenterology in 1992-1993. Retrospective collection of data on recurrence of local cancer, distant metastases, and over-all survival at the end of 1996.RESULTS:Of 268 patients, 77 (29{\%}) developed recurrent local cancer and/or distant metastases. Forty-eight (18{\%}) had local recurrence with a cumulative 5-year rate of 39{\%}. Distant metastases were seen in 54 (20{\%}). The local recurrence rate increased with increasing Dukes' tumour stage and was higher after operation by a non-specialist (30{\%}) than by a consultant, another specialist, or a surgeon under training and supervised by a consultant (15-17{\%}) (p = 0.04). Multiple regression showed that the recurrence rate was independent of tumour localisation, blood loss, transfusion, anastomotic leakage, and status of the surgeon. The cumulative crude 5-year survival was 50{\%} and independent of the status of the surgeon.DISCUSSION:Our relatively high local recurrence rate and the results in the literature after total mesorectal excision (TME) indicate that the conventional technique should be replaced by TME, which has become the recommended method in recent years. Furthermore, we propose a changed strategy in the treatment of rectal cancer. The patients should be treated in fewer departments with established teams of rectal cancer specialists taking part in all operations for rectal cancer.",
keywords = "Adenocarcinoma, Adult, Aged, Denmark, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Rectal Neoplasms, Retrospective Studies, Survival Rate",
author = "S B{\"u}low and Moesgaard, {F A} and Crone, {P O} and P Gandrup and J Holm and O Kronborg and H Hemmert-Lund and T Myrh{\o}j and Petersen, {R H} and N Qvist and Raskov, {H H} and H Thomsen",
year = "2001",
month = "7",
day = "2",
language = "Dansk",
volume = "163",
pages = "3793--7",
journal = "Ugeskrift for Laeger",
issn = "0041-5782",
publisher = "Almindelige Danske Laegeforening",
number = "27",

}

Bülow, S, Moesgaard, FA, Crone, PO, Gandrup, P, Holm, J, Kronborg, O, Hemmert-Lund, H, Myrhøj, T, Petersen, RH, Qvist, N, Raskov, HH & Thomsen, H 2001, 'Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti', Ugeskrift for Laeger, bind 163, nr. 27, s. 3793-7.

Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti. / Bülow, S; Moesgaard, F A; Crone, P O; Gandrup, P; Holm, J; Kronborg, O; Hemmert-Lund, H; Myrhøj, T; Petersen, R H; Qvist, N; Raskov, H H; Thomsen, H.

I: Ugeskrift for Laeger, Bind 163, Nr. 27, 02.07.2001, s. 3793-7.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti

AU - Bülow, S

AU - Moesgaard, F A

AU - Crone, P O

AU - Gandrup, P

AU - Holm, J

AU - Kronborg, O

AU - Hemmert-Lund, H

AU - Myrhøj, T

AU - Petersen, R H

AU - Qvist, N

AU - Raskov, H H

AU - Thomsen, H

PY - 2001/7/2

Y1 - 2001/7/2

N2 - INTRODUCTION:The aim of the study was to evaluate the incidence of recurrence of local cancer, distant metastases and survival after conventional low anterior resection for cure in patients with rectal carcinoma, on the basis of the poor prognosis after colorectal cancer in Denmark.MATERIAL AND METHODS:Consecutive patients operated on in the nine Danish departments of surgical gastroenterology in 1992-1993. Retrospective collection of data on recurrence of local cancer, distant metastases, and over-all survival at the end of 1996.RESULTS:Of 268 patients, 77 (29%) developed recurrent local cancer and/or distant metastases. Forty-eight (18%) had local recurrence with a cumulative 5-year rate of 39%. Distant metastases were seen in 54 (20%). The local recurrence rate increased with increasing Dukes' tumour stage and was higher after operation by a non-specialist (30%) than by a consultant, another specialist, or a surgeon under training and supervised by a consultant (15-17%) (p = 0.04). Multiple regression showed that the recurrence rate was independent of tumour localisation, blood loss, transfusion, anastomotic leakage, and status of the surgeon. The cumulative crude 5-year survival was 50% and independent of the status of the surgeon.DISCUSSION:Our relatively high local recurrence rate and the results in the literature after total mesorectal excision (TME) indicate that the conventional technique should be replaced by TME, which has become the recommended method in recent years. Furthermore, we propose a changed strategy in the treatment of rectal cancer. The patients should be treated in fewer departments with established teams of rectal cancer specialists taking part in all operations for rectal cancer.

AB - INTRODUCTION:The aim of the study was to evaluate the incidence of recurrence of local cancer, distant metastases and survival after conventional low anterior resection for cure in patients with rectal carcinoma, on the basis of the poor prognosis after colorectal cancer in Denmark.MATERIAL AND METHODS:Consecutive patients operated on in the nine Danish departments of surgical gastroenterology in 1992-1993. Retrospective collection of data on recurrence of local cancer, distant metastases, and over-all survival at the end of 1996.RESULTS:Of 268 patients, 77 (29%) developed recurrent local cancer and/or distant metastases. Forty-eight (18%) had local recurrence with a cumulative 5-year rate of 39%. Distant metastases were seen in 54 (20%). The local recurrence rate increased with increasing Dukes' tumour stage and was higher after operation by a non-specialist (30%) than by a consultant, another specialist, or a surgeon under training and supervised by a consultant (15-17%) (p = 0.04). Multiple regression showed that the recurrence rate was independent of tumour localisation, blood loss, transfusion, anastomotic leakage, and status of the surgeon. The cumulative crude 5-year survival was 50% and independent of the status of the surgeon.DISCUSSION:Our relatively high local recurrence rate and the results in the literature after total mesorectal excision (TME) indicate that the conventional technique should be replaced by TME, which has become the recommended method in recent years. Furthermore, we propose a changed strategy in the treatment of rectal cancer. The patients should be treated in fewer departments with established teams of rectal cancer specialists taking part in all operations for rectal cancer.

KW - Adenocarcinoma

KW - Adult

KW - Aged

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Rectal Neoplasms

KW - Retrospective Studies

KW - Survival Rate

M3 - Tidsskriftartikel

C2 - 11466988

VL - 163

SP - 3793

EP - 3797

JO - Ugeskrift for Laeger

JF - Ugeskrift for Laeger

SN - 0041-5782

IS - 27

ER -

Bülow S, Moesgaard FA, Crone PO, Gandrup P, Holm J, Kronborg O et al. Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti. Ugeskrift for Laeger. 2001 jul 2;163(27):3793-7.