Time trends, improvements and national auditing of rectal cancer management over an 18‐year period

Kodeda, Karl; Johansson, Robert; Zar, Niklas; Birgisson, Helgi; Dahlberg, Mikael; Skullman, S.; Lindmark, Gunilla; Glimelius, Bengt; Påhlman, Lars; Martling, Anna

doi:10.1111/codi.13060

Cited by 85 publications

(69 citation statements)

References 36 publications

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“…These changes include centralized and improved surgery, multidisciplinary teams [3][4][5], preoperative radiotherapy in rectal cancer [9,10] and more precise adjuvant treatments [6][7][8]. However, also the regional healthcare systems have changed accordingly, and based on a single clinical trial or study registry, it is challenging to analyze the impact of different changes in the treatment results of CRC.…”

Section: Discussionmentioning

confidence: 99%

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Trends in presentation, treatment and survival of 1777 patients with colorectal cancer over a decade: a Biobank study

et al. 2017

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Background: Most survival data in colorectal cancer (CRC) is derived from clinical trials or registerbased studies. Hospital Biobanks, linked with hospital electronic records, could serve as a data-gathering method based on consecutively collected tumor samples. The aim of this Biobank study was to analyze survival of colorectal patients diagnosed and treated in a single-center university hospital over a period of 12 years, and to evaluate factors contributing to outcome.

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Section: Discussionmentioning

confidence: 99%

“…Controlled quality and centralization of surgery, both in rectal [3,4] and colon cancer [5] and the use of adjuvant chemotherapy [6][7][8] have improved the survival of patients with CRC. Additionally, in rectal cancer, preoperative radiotherapy or chemoradiotherapy have significantly improved survival [9,10].…”

Section: Introductionmentioning

confidence: 99%

Trends in presentation, treatment and survival of 1777 patients with colorectal cancer over a decade: a Biobank study

et al. 2017

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“…The SCRCR is a national population-based registry that prospectively collects data for all patients with colorectal cancer. This registry has previously been described in detail [16, 20, 22]. Primary data—information about patients (age and gender), tumours (TNM stage), preoperative assessment, neoadjuvant treatment, surgical treatment, residual tumour status, and early complications—are reported 30 days after surgery or at diagnosis for patients not treated with surgery.…”

Section: Methodsmentioning

confidence: 99%

“…During the early years, most patients received 25 Gy/5d and immediate surgery, and only a few patients with locally advanced tumours received 50 Gy/25d, often combined with chemotherapy and delayed surgery. In 2013, approximately 80% of the patients who received neoadjuvant therapy had a short-course RT and the remaining had chemoradiotherapy [19, 22]. There were no standardised national follow-up guidelines during the period studied, but the patients were followed according to each hospital’s protocols.…”

Section: Methodsmentioning

confidence: 99%

The importance of rectal washout for the oncological outcome after Hartmann’s procedure for rectal cancer: analysis of population-based data from the Swedish Colorectal Cancer Registry

2017

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BackgroundDuring rectal cancer surgery the bowel may contain viable, exfoliated cancer cells, a potential source for local recurrence (LR). The amount and viability of these cells can be reduced using intraoperative rectal washout, a procedure that reduces the LR risk after anterior resection. The aim of this study was to analyse the impact of washout on oncological outcome when performed in Hartmann’s procedure (HP) for rectal cancer.MethodsA national cohort study on data for patients registered from 1995 to 2007 in the Swedish Colorectal Cancer Registry was carried out. The final analysis included patients belonging to TNM stages I–III who had undergone R0 HP with a registered 5-year follow-up. Multivariate analysis was performed.ResultsA total of 1188 patients were analysed (686 washout and 502 no washout). No differences were detected between the washout group and the no washout group concerning rates of LR [7% (49/686) vs. 10% (49/502); p = 0.13], distant metastasis (DM) [17% (119/686) vs. 18% (93/502); p = 0.65], and overall recurrence (OAR) [21% (145/686) vs. 24% (120/502); p = 0.29]. For both groups, the 5-year cancer-specific survival was below 50%. In multivariate analysis, washout neither decreased the risk of LR, DM, or OAR nor increased overall or the cancer-specific 5-year survival.ConclusionsThe oncological outcome did not improve when washout was performed in HP for rectal cancer.Electronic supplementary materialThe online version of this article (doi:10.1007/s10151-017-1637-5) contains supplementary material, which is available to authorized users.

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“…Patients diagnosed with rectal cancer in stage I-III 18-61 years of age 1996-2009, and treated curatively (n ¼ 3438) were identified in the Swedish Colorectal Cancer Register. The register contains comprehensive clinical information and covers >98% of all national invasive rectal adenocarcinomas (20,21).…”

Section: Study Populationmentioning

confidence: 99%

Work Loss Duration and Predictors Following Rectal Cancer Treatment among Patients with and without Prediagnostic Work Loss

Chen

Glimelius

Neovius

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: The number of working-age rectal cancer survivors is increasing due to early detection and improved treatment. However, work loss duration and predictors among them have not been studied thoroughly.Methods: We identified 3,438 patients with stage I-III rectal cancer, 18 to 61 years of age in the Swedish Colorectal Cancer Register 1996-2009. Information on work loss due to sick leave or disability pension was collected from 2 years before diagnosis to 5 years after (until December 31st, 2013). Incidence rate ratios (IRR) of work loss were estimated in a negative binominal model by clinical characteristics for the 1st and 2nd-5th years after diagnosis. Patients were stratified by prediagnostic work loss.Results: Patients without prediagnostic work loss (74%) experienced median 147 days (25th and 75th percentile: 55 and 281) of work loss during the 1st year after diagnosis. Work loss rates

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Time trends, improvements and national auditing of rectal cancer management over an 18‐year period

Cited by 85 publications

References 36 publications

Trends in presentation, treatment and survival of 1777 patients with colorectal cancer over a decade: a Biobank study

Trends in presentation, treatment and survival of 1777 patients with colorectal cancer over a decade: a Biobank study

The importance of rectal washout for the oncological outcome after Hartmann’s procedure for rectal cancer: analysis of population-based data from the Swedish Colorectal Cancer Registry

Work Loss Duration and Predictors Following Rectal Cancer Treatment among Patients with and without Prediagnostic Work Loss

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