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Colorectal Dis. 2011 Sep;13(9):1004-8. doi: 10.1111/j.1463-1318.2010.02360.x. Epub 2010 Jul 1.

Changes in the management and outcome of rectal cancer over a 10-year period in Oxford.

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Department of Colorectal Surgery, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK.



The changes in the management and outcome of rectal cancer in Oxford were studied over a 10-year period.


Rectal cancer data using a prospectively collected data base were divided into curative (global) and palliative groups. The global curative group was further divided into those with and without (selected group) the following features: emergency cases, local excision, salvage surgery for recurrence or incomplete local excision, metastatic disease, perioperative death, hereditary cancer, inflammatory bowel disease-related cancer, and synchronous cancer.


Between 1994 and 2003, 709 cases of rectal cancer were treated, 532 for cure and a selected group of 393 after removing patients with the aforementioned exclusions. For the selected group, the average follow-up was 51.2 months, overall survival 65.4% and cancer-specific survival 75.3%. There was no 2-year survival difference between each of the 10-year periods of study. Two-year local recurrence was 5.6% for the first 5-year period and 2.3% for the second (P = 0.11). MRI staging increased during the 10 years (0% in 1994; 66.7% in 2003) as did use of definitive chemoradiotherapy (dCRT) (0% in 1994; 64.7% in 2003). The anastomotic leakage rate was significantly higher in the second 5-year period (2.6%vs 9.6%; P = 0.01).


Despite increasing use of MRI and dCRT, 2-year survival and local recurrence were not significantly different within the 10 years studied.

[Indexed for MEDLINE]

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