Rectal cancer used to be the "bad boy" of the cancers of the colon and the rectum. As it appears, this may no longer be the case; a number of changes over the past few decades including standardized surgical technique (TME, total mesorectal excision), improved staging (use of magnetic resonance imaging) and careful selection of patients in need of radiotherapy BEFORE surgery, has lowered the rates of local recurrence and improved overall survival. Out group fairly recently published the result from the Norwegian database on colon and rectal cancer and found that rectal cancer survival has now indeed superseded that of colon cancer. Please see the full study published in the BJS:
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Nedrebø BS, Søreide K, Eriksen MT, Dørum LM, Kvaløy JT, Søreide JA, Kørner H;
Norwegian Colorectal Cancer Registry. Survival effect of implementing national
treatment strategies for curatively resected colonic and rectal cancer. Br J
Surg. 2011 May;98(5):716-23. doi: 10.1002/bjs.7426. Epub 2011 Feb 21
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In a recently released study available early online in the Acta Oncology we have further explored the survival differences over time. It appears that survival (or more precisely the excess mortality) differes over time during surgery. The clues into this may indeed be the answer to new and more appropriate ways of dealing with these two cancers in the future. Please see the early release in Acta Oncology:
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| Nedrebø BS, Søreide K, Eriksen MT, Kvaløy JT, Søreide JA, Kørner H. Excessmortality after curative surgery for colorectal cancer changes over time anddiffers for patients with colon versus rectal cancer. Acta Oncol. 2012 Oct 29.[Epub ahead of print] |
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