K Kodeda1, R Johansson2, N Zar3, H Birgisson4, M Dahlberg5, S Skullman6, G Lindmark7, B Glimelius8, L Påhlman4, A Martling9. 1. Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 2. Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden. 3. Department of Surgery, Ryhov County Hospital, Jönköping, Sweden. 4. Department of Surgical Science, Uppsala University, Uppsala, Sweden. 5. Department of Surgery and Perioperative Sciences, Umeå University, Umeå, Sweden. 6. Department of Surgery, Skaraborg Hospital - Skövde, Skövde, Sweden. 7. Department of Surgery, Helsingborg Hospital/Lund University, Helsingborg, Sweden. 8. Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden. 9. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Abstract
AIM: The main aims were to explore time trends in the management and outcome of patients with rectal cancer in a national cohort and to evaluate the possible impact of national auditing on overall outcomes. A secondary aim was to provide population-based data for appraisal of external validity in selected patient series. METHOD: Data from the Swedish ColoRectal Cancer Registry with virtually complete national coverage were utilized in this cohort study on 29 925 patients with rectal cancer diagnosed between 1995 and 2012. Of eligible patients, nine were excluded. RESULTS: During the study period, overall, relative and disease-free survival increased. Postoperative mortality after 30 and 90 days decreased to 1.7% and 2.9%. The 5-year local recurrence rate dropped to 5.0%. Resection margins improved, as did peri-operative blood loss despite more multivisceral resections being performed. Fewer patients underwent palliative resection and the proportion of non-operated patients increased. The proportions of temporary and permanent stoma formation increased. Preoperative radiotherapy and chemoradiotherapy became more common as did multidisciplinary team conferences. Variability in rectal cancer management between healthcare regions diminished over time when new aspects of patient care were audited. CONCLUSION: There have been substantial changes over time in the management of patients with rectal cancer, reflected in improved outcome. Much indirect evidence indicates that auditing matters, but without a control group it is not possible to draw firm conclusions regarding the possible impact of a quality control registry on faster shifts in time trends, decreased variability and improvements. Registry data were made available for reference. Colorectal Disease
AIM: The main aims were to explore time trends in the management and outcome of patients with rectal cancer in a national cohort and to evaluate the possible impact of national auditing on overall outcomes. A secondary aim was to provide population-based data for appraisal of external validity in selected patient series. METHOD: Data from the Swedish ColoRectal Cancer Registry with virtually complete national coverage were utilized in this cohort study on 29 925 patients with rectal cancer diagnosed between 1995 and 2012. Of eligible patients, nine were excluded. RESULTS: During the study period, overall, relative and disease-free survival increased. Postoperative mortality after 30 and 90 days decreased to 1.7% and 2.9%. The 5-year local recurrence rate dropped to 5.0%. Resection margins improved, as did peri-operative blood loss despite more multivisceral resections being performed. Fewer patients underwent palliative resection and the proportion of non-operated patients increased. The proportions of temporary and permanent stoma formation increased. Preoperative radiotherapy and chemoradiotherapy became more common as did multidisciplinary team conferences. Variability in rectal cancer management between healthcare regions diminished over time when new aspects of patient care were audited. CONCLUSION: There have been substantial changes over time in the management of patients with rectal cancer, reflected in improved outcome. Much indirect evidence indicates that auditing matters, but without a control group it is not possible to draw firm conclusions regarding the possible impact of a quality control registry on faster shifts in time trends, decreased variability and improvements. Registry data were made available for reference. Colorectal Disease
Authors: Ipek Sapci; Conor P Delaney; David Liska; Sudha Amarnath; Matthew F Kalady; Scott R Steele; Emre Gorgun Journal: J Gastrointest Surg Date: 2019-04-22 Impact factor: 3.452
Authors: Tania C Sluckin; Sanne-Marije J A Hazen; Karin Horsthuis; Regina G H Beets-Tan; Corrie A M Marijnen; Pieter J Tanis; Miranda Kusters Journal: Insights Imaging Date: 2022-10-20
Authors: Dan Asplund; Thue Bisgaard; David Bock; Jakob Burcharth; Elisabeth González; Eva Haglind; Yanislav Kolev; Peter Matthiessen; Carina Rosander; Jacob Rosenberg; Kenneth Smedh; Marina Åkerblom Sörensson; Eva Angenete Journal: Int J Colorectal Dis Date: 2017-09-14 Impact factor: 2.571
Authors: Anouck Haanappel; Hidde M Kroon; Dennis P Schaap; Sergei Bedrikovetski; Nagendra N Dudi-Venkata; Hong X Lee; Michelle L Thomas; Jianliang Liu; Maxime J M van der Valk; Harm J T Rutten; Geerard L Beets; Miranda Kusters; Tarik Sammour Journal: Front Oncol Date: 2019-12-03 Impact factor: 6.244
Authors: M Sörensson; D Asplund; P Matthiessen; J Rosenberg; T Hallgren; C Rosander; E González; D Bock; E Angenete Journal: Colorectal Dis Date: 2019-12-06 Impact factor: 3.788