Résumé
Objective: Compare the survival of middle and lower rectal cancer (MLRC) patients before and after the 1994 issue of rectal cancer (RC) consensus conference recommendations.
Methods: Cases of MLRC noted in the Herault department of France in 1992 (n = 58) and 2000 (n = 93) yielded exhaustive epidemiological, clinical-pathological and treatment data that were used to compare MLRC patient management and survival in these two periods.
Results: Significantly more lymph nodes (>= 8) were harvested in 2000 (>= 8, 47%) than in 1992. In all, 45 patients (77.6%) received radiotherapy in 1992, and 74 (82%) in 2000. Chemotherapy was employed in 15 patients (25.9%) in 1992 and in 39 patients (43%) in 2000. Chemotherapy and radiotherapy, together with sphincter conservation, were dependent upon the year. Overall 5-year relative survival for rectal cancer in the Herault department did not vary between 1992 (56%) and 2000 (56%). Independent poor prognostic factors were the same in both years: age over 75 years, lymph node involvement and metastases. Management place and year had no significant impact on prognosis.
Conclusion: The recommendations made have had little impact on disease management and the quality of anatomic pathology reports, and have not improved 5-year relative survival. (c) 2011 Elsevier Masson SAS. All rights reserved.