Locally Advanced Colorectal Cancer and the Right Surgical Treatment
Locally Advanced Colorectal Cancer and the Right Surgical Treatment
Govindarajan A, Coburn NG, Kiss A, Rabeneck L, Smith AJ, Law CH
J Natl Cancer Inst. 2006;98:1473-1481
Are patients with locally advanced colorectal cancer receiving optimal surgical treatment in the United States? The authors attempted to answer this question by reviewing national cancer statistics gathered by the Surveillance, Epidemiology and End Results (SEER) program during the period from 1988-2002. A total of 8380 patients were identified as having locally advanced adherent colorectal cancer that would require multi-organ resection for cure. Only one third had multi-organ surgical resection, yet this procedure offered a significant survival advantage -- an 11% improvement in overall survival compared with simpler types of resection for colon cancer, and a 19% improvement in survival for patients with rectal cancer. Younger patients and females were more likely to have adequate surgery.
As would be anticipated, this report finds a significant benefit from more radical surgery in patients with advanced colorectal cancer. However, only a third of all patients in the SEER program received appropriate surgery. The authors found regional differences in the frequency of performing radical surgery, suggesting that the selection criteria vary in different geographic areas. Since survival rates improve with adequate surgery, there is a need to determine why most patients are receiving inadequate surgery.
Abstract
Govindarajan A, Coburn NG, Kiss A, Rabeneck L, Smith AJ, Law CH
J Natl Cancer Inst. 2006;98:1473-1481
Are patients with locally advanced colorectal cancer receiving optimal surgical treatment in the United States? The authors attempted to answer this question by reviewing national cancer statistics gathered by the Surveillance, Epidemiology and End Results (SEER) program during the period from 1988-2002. A total of 8380 patients were identified as having locally advanced adherent colorectal cancer that would require multi-organ resection for cure. Only one third had multi-organ surgical resection, yet this procedure offered a significant survival advantage -- an 11% improvement in overall survival compared with simpler types of resection for colon cancer, and a 19% improvement in survival for patients with rectal cancer. Younger patients and females were more likely to have adequate surgery.
As would be anticipated, this report finds a significant benefit from more radical surgery in patients with advanced colorectal cancer. However, only a third of all patients in the SEER program received appropriate surgery. The authors found regional differences in the frequency of performing radical surgery, suggesting that the selection criteria vary in different geographic areas. Since survival rates improve with adequate surgery, there is a need to determine why most patients are receiving inadequate surgery.
Abstract
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