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Erschienen in: International Journal of Colorectal Disease 6/2015

01.06.2015 | Original Article

Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades

verfasst von: Fischer Joern, Hellmich Gunter, Jackisch Thomas, Puffer Erik, Zimmer Jörg, Bleyl Dorothea, Kittner Thomas, Witzigmann Helmut, Stelzner Sigmar

Erschienen in: International Journal of Colorectal Disease | Ausgabe 6/2015

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Abstract

Purpose

This study aimed to investigate the outcome for stage II and III rectal cancer patients compared to stage II and III colonic cancer patients with regard to 5-year cause-specific survival (CSS), overall survival, and local and combined recurrence rates over time.

Methods

This prospective cohort study identified 3,355 consecutive patients with adenocarcinoma of the colon or rectum and treated in our colorectal unit between 1981 and 2011, for investigation. The study was restricted to International Union Against Cancer (UICC) stages II and III. Postoperative mortality and histological incomplete resection were excluded, which left 995 patients with colonic cancer and 726 patients with rectal cancer for further analysis.

Results

Five-year CSS rates improved for colonic cancer from 65.0 % for patients treated between 1981 and 1986 to 88.1 % for patients treated between 2007 and 2011. For rectal cancer patients, the respective 5-year CSS rates improved from 53.4 % in the first observation period to 89.8 % in the second one. The local recurrence rate for rectal cancer dropped from 34.2 % in the years 1981–1986 to 2.1 % in the years 2007–2011. In the last decade of observation, prognosis for rectal cancer was equal to that for colon cancer (CSS 88.6 vs. 86.7 %, p = 0.409).

Conclusion

Survival of patients with colon and rectal cancer has continued to improve over the last three decades. After major changes in treatment strategy including introduction of total mesorectal excision and neoadjuvant (radio)chemotherapy, prognosis for stage II and III rectal cancer is at least as good as for stage II and III colonic cancer.
Literatur
1.
Zurück zum Zitat Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A (1999) Survival of cancer patients in Europe: the EUROCARE-2 Study. IARC Scientific Publication 151 Berrino F, Capocaccia R, Estève J, Gatta G, Hakulinen T, Micheli A, Sant M, Verdecchia A (1999) Survival of cancer patients in Europe: the EUROCARE-2 Study. IARC Scientific Publication 151
2.
Zurück zum Zitat De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, Trama A, Visser O, Brenner H, Ardanaz E, Bielska-Lasota M, Engholm G, Nennecke A, Siesling S, Berrino F, Capocaccia R, the EUROCARE-5 Working Group (2013) Cancer survival in Europe 1997–2007 by country and age: results of the EUROCARE-5-a population-based study. Lancet Oncol. 1470-2045(13)70546-1. doi:10.1016/S1470-2045(13)70546-1 De Angelis R, Sant M, Coleman MP, Francisci S, Baili P, Pierannunzio D, Trama A, Visser O, Brenner H, Ardanaz E, Bielska-Lasota M, Engholm G, Nennecke A, Siesling S, Berrino F, Capocaccia R, the EUROCARE-5 Working Group (2013) Cancer survival in Europe 1997–2007 by country and age: results of the EUROCARE-5-a population-based study. Lancet Oncol. 1470-2045(13)70546-1. doi:10.​1016/​S1470-2045(13)70546-1
3.
Zurück zum Zitat Andreoni B, Chiappa A, Bertani E, Bellomi M, Orecchia R, Zampino MG, Fazio N, Venturino M, Orsi F, Sonzogni A, Pace U, Monfardini L (2007) Surgical outcomes for colon and rectal cancer over a decade: results from a consecutive monocentric experience in 902 unselected patients. World J Surg Oncol 5:73–81PubMedCentralCrossRefPubMed Andreoni B, Chiappa A, Bertani E, Bellomi M, Orecchia R, Zampino MG, Fazio N, Venturino M, Orsi F, Sonzogni A, Pace U, Monfardini L (2007) Surgical outcomes for colon and rectal cancer over a decade: results from a consecutive monocentric experience in 902 unselected patients. World J Surg Oncol 5:73–81PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Renouf DJ, Woods R, Speers C, Hay J, Phang PT, Fitzgerald C, Kennecke H (2013) Improvements in 5-year outcomes of stage II/III rectal cancer relative to colon cancer. Am J Clin Oncol 36:558–564CrossRefPubMed Renouf DJ, Woods R, Speers C, Hay J, Phang PT, Fitzgerald C, Kennecke H (2013) Improvements in 5-year outcomes of stage II/III rectal cancer relative to colon cancer. Am J Clin Oncol 36:558–564CrossRefPubMed
5.
Zurück zum Zitat Rutter CM, Johnson EA, Feuer EJ, Knudsen AB, Kuntz KM, Schrag D (2013) Secular trends in colon and rectal cancer relative survival. J Natl Cancer Inst 105:1806–1813PubMedCentralCrossRefPubMed Rutter CM, Johnson EA, Feuer EJ, Knudsen AB, Kuntz KM, Schrag D (2013) Secular trends in colon and rectal cancer relative survival. J Natl Cancer Inst 105:1806–1813PubMedCentralCrossRefPubMed
6.
Zurück zum Zitat Martling AL, Holm T, Rutqvist LE et al (2000) Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet 356:93–96CrossRefPubMed Martling AL, Holm T, Rutqvist LE et al (2000) Effect of a surgical training programme on outcome of rectal cancer in the County of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet 356:93–96CrossRefPubMed
7.
Zurück zum Zitat Wibe A, Moller B, Norstein J et al (2002) A national strategic change in treatment policy for rectal cancer—implementation of total mesorectal excision as routine treatment in Norway. A national audit. Dis Colon Rectum 45:857–866CrossRefPubMed Wibe A, Moller B, Norstein J et al (2002) A national strategic change in treatment policy for rectal cancer—implementation of total mesorectal excision as routine treatment in Norway. A national audit. Dis Colon Rectum 45:857–866CrossRefPubMed
8.
Zurück zum Zitat Kapiteijn E, Puffer H, van de Velde CJ (2002) Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands. Br J Surg 89:1142–1149CrossRefPubMed Kapiteijn E, Puffer H, van de Velde CJ (2002) Impact of the introduction and training of total mesorectal excision on recurrence and survival in rectal cancer in The Netherlands. Br J Surg 89:1142–1149CrossRefPubMed
9.
Zurück zum Zitat Heald RJ, Ryall RDH (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1479–82 Heald RJ, Ryall RDH (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1479–82
10.
Zurück zum Zitat Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2:996–999CrossRefPubMed Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2:996–999CrossRefPubMed
11.
Zurück zum Zitat Tilney HS, Rasheed S, Northover JM, Tekkis P (2009) The influence of circumferential resection margins on long-term outcomes following rectal cancer surgery. Dis Colon Rectum 52(10):1723–1729CrossRefPubMed Tilney HS, Rasheed S, Northover JM, Tekkis P (2009) The influence of circumferential resection margins on long-term outcomes following rectal cancer surgery. Dis Colon Rectum 52(10):1723–1729CrossRefPubMed
12.
Zurück zum Zitat The MERCURY study Group (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243(1):132–139CrossRef The MERCURY study Group (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243(1):132–139CrossRef
13.
Zurück zum Zitat Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740CrossRefPubMed Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C et al (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351(17):1731–1740CrossRefPubMed
14.
Zurück zum Zitat Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Color Dis 11(4):354–365CrossRef Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation—technical notes and outcome. Color Dis 11(4):354–365CrossRef
15.
Zurück zum Zitat Gill S, Loprinzi CL, Sargent DJ, Thome SD, Alberts SR et al (2004) Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol 22(10):1797–1806CrossRefPubMed Gill S, Loprinzi CL, Sargent DJ, Thome SD, Alberts SR et al (2004) Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol 22(10):1797–1806CrossRefPubMed
16.
Zurück zum Zitat Hermanek P, Mansmann U, Staimmer DS, Riedl S, Hermanek P (2000) The German experience: the surgeon as a prognostic factor in colon and rectal cancer surgery. Surg Oncol Clin N Am 9(1):33–49, vi PubMed Hermanek P, Mansmann U, Staimmer DS, Riedl S, Hermanek P (2000) The German experience: the surgeon as a prognostic factor in colon and rectal cancer surgery. Surg Oncol Clin N Am 9(1):33–49, vi PubMed
17.
Zurück zum Zitat Nedrebo BS, Soreide K, Eriksen MT, Dorum LM, Kvaloy JT, Soreide JA, Korner H (2011) Survival effect of implementing national treatment strategies for curatively resected colonic and rectal cancer. Br J Surg 98:716–723CrossRefPubMed Nedrebo BS, Soreide K, Eriksen MT, Dorum LM, Kvaloy JT, Soreide JA, Korner H (2011) Survival effect of implementing national treatment strategies for curatively resected colonic and rectal cancer. Br J Surg 98:716–723CrossRefPubMed
18.
Zurück zum Zitat Van Gijn W, Krijnen P, Lemmens VE, den Dulk M, Putter H, van de Velde CJ (2009) Quality assurance in rectal cancer treatment in the Netherlands: a catch up compared to colon cancer treatment. Eur J Surg Oncol 36:340–344CrossRefPubMed Van Gijn W, Krijnen P, Lemmens VE, den Dulk M, Putter H, van de Velde CJ (2009) Quality assurance in rectal cancer treatment in the Netherlands: a catch up compared to colon cancer treatment. Eur J Surg Oncol 36:340–344CrossRefPubMed
19.
Zurück zum Zitat Birgisson H, Talbäck M, Gunnarsson U, Pahlman L, Glimelius B (2005) Improved survival in cancer of the colon and rectum in Sweden. EJSO 31:845–853CrossRefPubMed Birgisson H, Talbäck M, Gunnarsson U, Pahlman L, Glimelius B (2005) Improved survival in cancer of the colon and rectum in Sweden. EJSO 31:845–853CrossRefPubMed
20.
Zurück zum Zitat Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26(2):303–312CrossRefPubMed Nagtegaal ID, Quirke P (2008) What is the role for the circumferential margin in the modern treatment of rectal cancer? J Clin Oncol 26(2):303–312CrossRefPubMed
21.
Zurück zum Zitat Nagtegaal ID, van de Velde CJ, van der Worp E, Kapiteijn E, Quirke P, van Krieken JH (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol 20:1729–1734CrossRefPubMed Nagtegaal ID, van de Velde CJ, van der Worp E, Kapiteijn E, Quirke P, van Krieken JH (2002) Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J Clin Oncol 20:1729–1734CrossRefPubMed
22.
Zurück zum Zitat Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, Dixon MF, Quirke P (1994) Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344(8924):707–711CrossRefPubMed Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, Dixon MF, Quirke P (1994) Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344(8924):707–711CrossRefPubMed
23.
Zurück zum Zitat Quirke P, Steele R, Monson J, Grieve R et al (2009) Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 373(9666):821–828PubMedCentralCrossRefPubMed Quirke P, Steele R, Monson J, Grieve R et al (2009) Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial. Lancet 373(9666):821–828PubMedCentralCrossRefPubMed
24.
Zurück zum Zitat Taylor FG, Quirke P, Heald RJ, Moran BJ, Blomqvist L, Swift IR, Sebag-Montefiore D, Tekkis P, Brown G (2014) Preoperative magnetic resonance imaging assessment of circumferential resection Margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY Study. J Clin Oncol 32(1):34–43CrossRefPubMed Taylor FG, Quirke P, Heald RJ, Moran BJ, Blomqvist L, Swift IR, Sebag-Montefiore D, Tekkis P, Brown G (2014) Preoperative magnetic resonance imaging assessment of circumferential resection Margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY Study. J Clin Oncol 32(1):34–43CrossRefPubMed
25.
Zurück zum Zitat Brown G (2005) Thin section MRI in multidisciplinary pre-operative decision making for patients with rectal cancer. Br J Radiol 78:S117–S127CrossRefPubMed Brown G (2005) Thin section MRI in multidisciplinary pre-operative decision making for patients with rectal cancer. Br J Radiol 78:S117–S127CrossRefPubMed
26.
Zurück zum Zitat MERCURY Study Group (2006) Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 333:779PubMedCentralCrossRef MERCURY Study Group (2006) Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 333:779PubMedCentralCrossRef
27.
Zurück zum Zitat Iannicelli E, Di Renzo S, Ferri M et al (2014) Accuracy of high-resolution MRI with lumen distention in rectal cancer staging and circumferential margin involvement prediction. Korean J Radiol 15(1):37–44PubMedCentralCrossRefPubMed Iannicelli E, Di Renzo S, Ferri M et al (2014) Accuracy of high-resolution MRI with lumen distention in rectal cancer staging and circumferential margin involvement prediction. Korean J Radiol 15(1):37–44PubMedCentralCrossRefPubMed
28.
Zurück zum Zitat Burton S, Brown G, Daniels I, Norman A, Swift I, Abulafi M, Wotherspoon A, Tait D (2006) MRI identified prognostic features of tumors in distal sigmoid, rectosigmoid, and upper rectum: treatment with radiotherapy and chemotherapy. Int J Radiat Oncol Biol 65(2):445–451CrossRef Burton S, Brown G, Daniels I, Norman A, Swift I, Abulafi M, Wotherspoon A, Tait D (2006) MRI identified prognostic features of tumors in distal sigmoid, rectosigmoid, and upper rectum: treatment with radiotherapy and chemotherapy. Int J Radiat Oncol Biol 65(2):445–451CrossRef
29.
Zurück zum Zitat Burton S, Brown G, Daniels IR, Norman AR, Mason B, Cunningham D, Hospital RM, Network CC (2006) MRI directed multidisciplinary team preoperative treatment strategy: the way to eliminate positive circumferential margins? Br J Cancer 94:351–357PubMedCentralCrossRefPubMed Burton S, Brown G, Daniels IR, Norman AR, Mason B, Cunningham D, Hospital RM, Network CC (2006) MRI directed multidisciplinary team preoperative treatment strategy: the way to eliminate positive circumferential margins? Br J Cancer 94:351–357PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Perrakis A, Weber K, Merkel S, Matzel K, Agaimy A, Gebbert C, Hohenberger W (2014) Lymph node metastasis of carcinomas of transverse colon including flexures. Consideration of the extramesocolic lymph node stations. Int J Color Dis 29:1223–1229CrossRef Perrakis A, Weber K, Merkel S, Matzel K, Agaimy A, Gebbert C, Hohenberger W (2014) Lymph node metastasis of carcinomas of transverse colon including flexures. Consideration of the extramesocolic lymph node stations. Int J Color Dis 29:1223–1229CrossRef
31.
Zurück zum Zitat Weber K, Merkel S, Perrakis A, Hohenberger W (2013) Is there a disadvantage to radical lymph node dissection in colon cancer? Int J Color Dis 28:217–226CrossRef Weber K, Merkel S, Perrakis A, Hohenberger W (2013) Is there a disadvantage to radical lymph node dissection in colon cancer? Int J Color Dis 28:217–226CrossRef
32.
Zurück zum Zitat André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, Bonetti A, Clingan P, Bridgewater J, Rivera F, de Gramont A (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27(19):3109–3116CrossRefPubMed André T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, Bonetti A, Clingan P, Bridgewater J, Rivera F, de Gramont A (2009) Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol 27(19):3109–3116CrossRefPubMed
33.
Zurück zum Zitat Gunnarsson U (2003) Quality assurance in surgical oncology. Colorectal cancer as an example. Eur J Surg Oncol 29:89–94CrossRefPubMed Gunnarsson U (2003) Quality assurance in surgical oncology. Colorectal cancer as an example. Eur J Surg Oncol 29:89–94CrossRefPubMed
34.
Zurück zum Zitat Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum 42:770–775CrossRefPubMed Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum 42:770–775CrossRefPubMed
35.
Zurück zum Zitat Topova L, Hellmich G, Puffer E, Schubert C, Christen N, Boldt T, Wiedemann B, Witzigmann H, Stelzner S (2011) Prognostic value of tumor response to neoadjuvant therapy in rectal carcinoma. Dis Colon Rectum 54(4):401–411CrossRefPubMed Topova L, Hellmich G, Puffer E, Schubert C, Christen N, Boldt T, Wiedemann B, Witzigmann H, Stelzner S (2011) Prognostic value of tumor response to neoadjuvant therapy in rectal carcinoma. Dis Colon Rectum 54(4):401–411CrossRefPubMed
36.
Zurück zum Zitat Stelzner S, Hellmich G, Koch R, Witzigmann H (2009) Exactitude of relative survival compared with cause-specific survival and competing risk estimations based on a clinical database of patients with colorectal carcinoma. Dis Colon Rectum 52(7):1264–1271CrossRefPubMed Stelzner S, Hellmich G, Koch R, Witzigmann H (2009) Exactitude of relative survival compared with cause-specific survival and competing risk estimations based on a clinical database of patients with colorectal carcinoma. Dis Colon Rectum 52(7):1264–1271CrossRefPubMed
37.
Zurück zum Zitat Holm T, Johansson H, Cedermark B, Ekelund G, Rutquist LE (1997) Influence of hospital- and surgeon-related factors on outcome after treatment of rectal cancer with or without radiotherapy. Br J Surg 84:657–663CrossRefPubMed Holm T, Johansson H, Cedermark B, Ekelund G, Rutquist LE (1997) Influence of hospital- and surgeon-related factors on outcome after treatment of rectal cancer with or without radiotherapy. Br J Surg 84:657–663CrossRefPubMed
38.
Zurück zum Zitat Ptok H, Ruppert R, Stassburg J, Maurer CA, Oberholzer K, Junginger T, Merkel S, Hermanek P (2013) Pretherapeutic MRI for decision-making regarding selective neoadjuvant radiochemotherapy for rectal carcinoma: interim analysis of a multicentric prospective observational study. J Magn Reson Imaging 37(5):1122–1128CrossRefPubMed Ptok H, Ruppert R, Stassburg J, Maurer CA, Oberholzer K, Junginger T, Merkel S, Hermanek P (2013) Pretherapeutic MRI for decision-making regarding selective neoadjuvant radiochemotherapy for rectal carcinoma: interim analysis of a multicentric prospective observational study. J Magn Reson Imaging 37(5):1122–1128CrossRefPubMed
Metadaten
Titel
Outcome for stage II and III rectal and colon cancer equally good after treatment improvement over three decades
verfasst von
Fischer Joern
Hellmich Gunter
Jackisch Thomas
Puffer Erik
Zimmer Jörg
Bleyl Dorothea
Kittner Thomas
Witzigmann Helmut
Stelzner Sigmar
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 6/2015
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-015-2219-5

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