Changes in outcome following surgery for colorectal cancer: one surgeon's experience

Colorectal cancer (CRC) has the second highest mortality rate of all cancers in Ireland. Developments in imaging, surgical technique, and perioperative care in the last two decades have altered management. To determine whether outcome following surgery for CRC in the mid-west has changed over a 22-y...

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Bibliographic Details
Published in:Irish journal of medical science 2005-10, Vol.174 (4), p.10-16
Main Authors: Kiely, J M, Kavanagh, E G, Guiney, A M, Fiuza-Castineira, C, Delaney, P V
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - methods
Biopsy, Needle
Cause of Death
Cohort Studies
Colectomy - adverse effects
Colectomy - methods
Colonoscopy - methods
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Female
Humans
Immunohistochemistry
Incidence
Ireland - epidemiology
Male
Middle Aged
Neoplasm Staging
Postoperative Complications - mortality
Retrospective Studies
Risk Assessment
Sex Distribution
Survival Analysis
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Summary:Colorectal cancer (CRC) has the second highest mortality rate of all cancers in Ireland. Developments in imaging, surgical technique, and perioperative care in the last two decades have altered management. To determine whether outcome following surgery for CRC in the mid-west has changed over a 22-year period. Four hundred and twenty-two patients were divided into two time periods: Group A (1980-1991, n = 203) and Group B (1992-2002, n = 219) and demographic, inpatient, and survival data were reviewed. The mean age was 67 years, 59% were male. Group B patients had less advanced disease at presentation (Dukes' stage D 14% vs 22%, p < 0.05), fewer perioperative complications (13% vs 23%, p < 0.05), and fewer local recurrences (6.8% vs 11.8%, p < 0.05) than Group A. No difference in 30-day mortality rate or survival was detected. Although perioperative CRC management has improved, methods of earlier diagnosis and improvements in adjuvant therapy should be explored to improve survival.
ISSN:0021-1265
1863-4362
DOI:10.1007/BF03168975