Colorectal cancer in Slovenia at the turn of the century

Improved Outcome of Patients with Colorectal Cancer: The Ljubljana University Medical Centre Experience

“…Patients with rectal cancer invading into the muscularis propria or regional lymph node can benefit from preoperative RT/KT [14]. In the USA, postoperative CT is considered to be the adjuvant therapy of choice [8, 17]. Patients with resectable T3, N0 or any TNM stage II-III lesions receive preoperative continuous infusional 5-florouracil/RT as the preferred treatment nowadays [18, 19, 23].…”

“…Most European investigators used to advocate preoperative intensive short-course irradiation instead [8, 17]. Preoperative chemoradiation (a long course of 42–50 Gy RT given over 4–6 weeks/5-florouracil, LV) has become a new standard in the treatment of patients with locally advanced rectal cancer [20, 21].…”

“…Improvement in survival rates may be attributed to several factors: peri- and postoperative mortality has declined (table 2) [10]; the introduction of antibiotic prophylaxis, improved anesthetic surveillance and refined surgical techniques may also have played an important role [11], and standard and extended radical operations involving radicular ligation of regional vessels have been introduced along with the monitoring of postoperative complications and mortality [8]. …”

“…Due to the increasing number of treatment options, preoperative staging of rectal cancer has gained profound importance [8]. Patients with rectal cancer invading into the muscularis propria or regional lymph node can benefit from preoperative RT/KT [14].…”

“…The proposed guidelines for treatment of gastrointestinal tumors were adopted and implemented in practice at the Department of Abdominal Surgery, University Medical Centre Ljubljana, at the end of 1995. In 1997, the document was published and distributed among all clinicians dealing with this disease in Slovenia [8]. …”