Evidence of improving survival of patients with rectal cancer in France: a population based study
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 dia...
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| Veröffentlicht in: | Gut 1999-03, Vol.44 (3), p.377-381 |
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| creator | Finn-Faivre, C Maurel, J Benhamiche, A M Herbert, C Mitry, E Launoy, G Faivre, J |
| description | 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. |
| doi_str_mv | 10.1136/gut.44.3.377 |
| format | Article |
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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.</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>EISSN: 1458-3288</identifier><identifier>DOI: 10.1136/gut.44.3.377</identifier><identifier>PMID: 10026324</identifier><identifier>CODEN: GUTTAK</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Society of Gastroenterology</publisher><subject>Adolescent ; Adult ; Age ; Aged ; Biological and medical sciences ; cancer registries ; Cancer therapies ; Child ; Child, Preschool ; Colorectal cancer ; Confidence intervals ; Disease Management ; Female ; France - epidemiology ; Gastroenterology. Liver. Pancreas. Abdomen ; Gastrointestinal Cancer ; Health risk assessment ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Male ; Medical prognosis ; Medical sciences ; Middle Aged ; Mortality ; Multivariate Analysis ; Neoplasm Staging ; Population ; Prognosis ; Radiation therapy ; rectal cancer ; Rectal Neoplasms - diagnosis ; Rectal Neoplasms - mortality ; Rectal Neoplasms - therapy ; stage at diagnosis ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Surgical Procedures, Operative - trends ; survival ; Survival analysis ; Survival Rate ; Time Factors ; time trends ; treatment ; Trends ; Tumors ; Urban areas</subject><ispartof>Gut, 1999-03, Vol.44 (3), p.377-381</ispartof><rights>British Society of Gastroenterology</rights><rights>1999 INIST-CNRS</rights><rights>Copyright: 1999 British Society of Gastroenterology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b507t-c91bbb08a3b529d0f1fd887e47e038c634480ce3d4ca29c966accf3b0cfe5d8d3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1727407/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1727407/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1691817$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10026324$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Finn-Faivre, C</creatorcontrib><creatorcontrib>Maurel, J</creatorcontrib><creatorcontrib>Benhamiche, A M</creatorcontrib><creatorcontrib>Herbert, C</creatorcontrib><creatorcontrib>Mitry, E</creatorcontrib><creatorcontrib>Launoy, G</creatorcontrib><creatorcontrib>Faivre, J</creatorcontrib><title>Evidence of improving survival of patients with rectal cancer in France: a population based study</title><title>Gut</title><addtitle>Gut</addtitle><description>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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>cancer registries</subject><subject>Cancer therapies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Colorectal cancer</subject><subject>Confidence intervals</subject><subject>Disease Management</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gastrointestinal Cancer</subject><subject>Health risk assessment</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Neoplasm Staging</subject><subject>Population</subject><subject>Prognosis</subject><subject>Radiation therapy</subject><subject>rectal cancer</subject><subject>Rectal Neoplasms - diagnosis</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - therapy</subject><subject>stage at diagnosis</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Surgical Procedures, Operative - trends</subject><subject>survival</subject><subject>Survival analysis</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>time trends</subject><subject>treatment</subject><subject>Trends</subject><subject>Tumors</subject><subject>Urban areas</subject><issn>0017-5749</issn><issn>1468-3288</issn><issn>1458-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kc1v1DAQxS0EokvhxhlZApULWezY8QeHStWqpaCqCAkqbpbjOFsvSZzaSaD_PY6yagsHTh7N_Pz0Zh4ALzFaY0zY--04rCldkzXh_BFYYcpERnIhHoMVQphnBafyADyLcYcQEkLip-AAI5QzktMV0KeTq2xnLPQ1dG0f_OS6LYxjmNykm7nb68HZbojwlxuuYbBmSH2j058AXQfPwlx-gBr2vh-bBPsOljraCsZhrG6fgye1bqJ9sX8Pwfez02-b8-ziy8dPm5OLrCwQHzIjcVmWSGhSFrmsUI3rSghuKbeICMMIpQIZSypqdC6NZEwbU5MSmdoWlajIIThedPuxbG1lkuWgG9UH1-pwq7x26u9J567V1k8K85xTxJPA0V4g-JvRxkG1LhrbNLqzfoyKyUKmg4oEvv4H3PkxdGm5pMWlZEjKIlHvFsoEH2Ow9Z0VjNScnErJKUoVUSm5hL96aP8BvESVgDd7QEejm3o-u4v3HJNY4FknWzAXB_v7bqzDT8U44YW6vNqoH-Lq8ivNP6t5mbcLX7a7_zv8A7urvyY</recordid><startdate>19990301</startdate><enddate>19990301</enddate><creator>Finn-Faivre, C</creator><creator>Maurel, J</creator><creator>Benhamiche, A M</creator><creator>Herbert, C</creator><creator>Mitry, E</creator><creator>Launoy, G</creator><creator>Faivre, J</creator><general>BMJ Publishing Group Ltd and British Society of Gastroenterology</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19990301</creationdate><title>Evidence of improving survival of patients with rectal cancer in France: a population based study</title><author>Finn-Faivre, C ; Maurel, J ; Benhamiche, A M ; Herbert, C ; Mitry, E ; Launoy, G ; Faivre, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b507t-c91bbb08a3b529d0f1fd887e47e038c634480ce3d4ca29c966accf3b0cfe5d8d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>cancer registries</topic><topic>Cancer therapies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Colorectal cancer</topic><topic>Confidence intervals</topic><topic>Disease Management</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gastrointestinal Cancer</topic><topic>Health risk assessment</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Neoplasm Staging</topic><topic>Population</topic><topic>Prognosis</topic><topic>Radiation therapy</topic><topic>rectal cancer</topic><topic>Rectal Neoplasms - diagnosis</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - therapy</topic><topic>stage at diagnosis</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Surgical Procedures, Operative - trends</topic><topic>survival</topic><topic>Survival analysis</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>time trends</topic><topic>treatment</topic><topic>Trends</topic><topic>Tumors</topic><topic>Urban areas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Finn-Faivre, C</creatorcontrib><creatorcontrib>Maurel, J</creatorcontrib><creatorcontrib>Benhamiche, A M</creatorcontrib><creatorcontrib>Herbert, C</creatorcontrib><creatorcontrib>Mitry, E</creatorcontrib><creatorcontrib>Launoy, G</creatorcontrib><creatorcontrib>Faivre, J</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Finn-Faivre, C</au><au>Maurel, J</au><au>Benhamiche, A M</au><au>Herbert, C</au><au>Mitry, E</au><au>Launoy, G</au><au>Faivre, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evidence of improving survival of patients with rectal cancer in France: a population based study</atitle><jtitle>Gut</jtitle><addtitle>Gut</addtitle><date>1999-03-01</date><risdate>1999</risdate><volume>44</volume><issue>3</issue><spage>377</spage><epage>381</epage><pages>377-381</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><eissn>1458-3288</eissn><coden>GUTTAK</coden><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.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Society of Gastroenterology</pub><pmid>10026324</pmid><doi>10.1136/gut.44.3.377</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Age Aged Biological and medical sciences cancer registries Cancer therapies Child Child, Preschool Colorectal cancer Confidence intervals Disease Management Female France - epidemiology Gastroenterology. Liver. Pancreas. Abdomen Gastrointestinal Cancer Health risk assessment Hospitals Humans Infant Infant, Newborn Male Medical prognosis Medical sciences Middle Aged Mortality Multivariate Analysis Neoplasm Staging Population Prognosis Radiation therapy rectal cancer Rectal Neoplasms - diagnosis Rectal Neoplasms - mortality Rectal Neoplasms - therapy stage at diagnosis Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Surgical Procedures, Operative - trends survival Survival analysis Survival Rate Time Factors time trends treatment Trends Tumors Urban areas |
| title | Evidence of improving survival of patients with rectal cancer in France: a population based study |
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