Trends in the United States for the management of adenocarcinoma of the rectum.

Data from surveys conducted by the Commission on Cancer of the American College of Surgeons were examined to identify recent trends in the treatment of carcinoma of the rectum. Between 1973 and 1978, the stage of disease at diagnosis for the total series changed little, but significant upgrading in the stage of disease at diagnosis for the black patients was observed. There was increasing use of a multimodality approach to treatment combining operation with radiotherapy. The use of chemotherapy alone or in combination with other therapies, while never widely used, declined during the interval observed. Significant changes occurred in the type of operations performed for carcinoma in the upper two-thirds of the rectum. During this interval, abdominoperineal resection was increasingly being displaced by low anterior resection. The trend toward multimodality treatment and the use of effective sphincter preserving procedures represent significant changes noted in this survey in the therapy of carcinoma of the rectum.