Improved overall survival for patients with rectal cancer since 1990: The effects of TME surgery and pre-operative radiotherapy

被引：76

作者：

den Dulk, Marcel ^{[1
]}

Krijnen, Pieta ^{[2
]}

Marijnen, Corrie A. M. ^{[3
]}

Rutten, Harm J. ^{[4
]}

van de Poll-Franse, Lonneke V. ^{[5
]}

Putter, Hein ^{[6
]}

Kranenbarg, Elma Meershoek-Klein ^{[1
]}

Jansen-Landheer, Marlies L. E. A. ^{[2
]}

Coebergh, Jan-Willem W. ^{[5
,7
]}

van de Velde, Cornelis J. H. ^{[1
]}

机构：

[1] Leiden Univ, Med Ctr, Dept Surg, NL-2300 RC Leiden, Netherlands

[2] Comprehens Canc Ctr W IKW, Leiden Canc Registry, Leiden, Netherlands

[3] NKI AvL, Dept Radiotherapy, Amsterdam, Netherlands

[4] Catharina Hosp, Dept Surg, Eindhoven, Netherlands

[5] Comprehens Canc Ctr S IKZ, Eindhoven Canc Registry, Eindhoven, Netherlands

[6] Leiden Univ, Med Ctr, Dept Med Stat, NL-2300 RC Leiden, Netherlands

[7] Erasmus Univ, Med Ctr, Dept Publ Hlth, Rotterdam, Netherlands

来源：

EUROPEAN JOURNAL OF CANCER | 2008年 / 44卷 / 12期

关键词：

rectal cancer; total mesorectal excision (TME); overall survival; (neo)adjuvant treatment; training; quality assurance;

D O I：

10.1016/j.ejca.2008.05.004

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: The aim was to study the effects of the introduction of TME surgery and pre-operative radiotherapy on overall survival (OS) by comparing patients treated in the period before (1990-1995), during (1996-1999) and after (2000-2002) the TME trial. Patients and methods: Patients diagnosed with rectal carcinoma in the region of Comprehensive Cancer Centres South and West were used (n = 3179). Results: Five-year OS was, respectively, 56%, 62% and 65% in the pre-trial, trial and post-trial periods (p < 0.001). Pre-operative RT was increasingly used over time and significantly related to OS in the post-trial period (p = 0.002), but not in the pre-trial and trial periods. Conclusions: Population-based OS improved markedly since the introduction of TME surgery. With standardised TME surgery, pre-operative RT improved OS, whereas withholding pre-operative RT was associated with a poorer prognosis. The present study supports that pre-operative RT was correctly introduced as a standard treatment before TME surgery in our national guideline. (C) 2008 Elsevier Ltd. All rights reserved.

引用

页码：1710 / 1716

页数：7

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