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.
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). (...)
Mots-clés Pascal : Carcinome, Rectum, Etude longitudinale, Survie, Amélioration, Pronostic, Conduite à tenir, Homme, France, Europe, Tumeur maligne, Appareil digestif pathologie, Intestin pathologie, Rectum pathologie
Mots-clés Pascal anglais : Carcinoma, Rectum, Follow up study, Survival, Improvement, Prognosis, Clinical management, Human, France, Europe, Malignant tumor, Digestive diseases, Intestinal disease, Rectal disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0154228
Code Inist : 002B13B01. Création : 16/11/1999.