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Palliative surgery for rectal cancer in a national cohort
Author(s) -
Sigurdsson H. K.,
Kørner H.,
Dahl O.,
Skarstein A.,
Søreide J. A.
Publication year - 2008
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2007.01376.x
Subject(s) - medicine , cohort , surgery , cancer , disease , colorectal cancer , palliative care , stage (stratigraphy) , cohort study , overall survival , nursing , biology , paleontology
Objective Whether resection of the primary tumour is of benefit to patients with incurable rectal cancer (RC) remains a matter of debate. In this study we analyse prospectively recorded data from a national cohort. Method Among 4831 patients diagnosed with RC between 1997 and 2001, 838 (17%) patients were treated with palliative surgery. Patients were stratified according to disease stage, age and type of surgery. Results A significantly longer median survival, 12 (range 10–13) months, was observed in patients treated with resection of the primary tumour compared with 5 (range 4–6) months in patients treated with nonresective procedures ( P < 0.001). Median survival in months was significantly ( P < 0.001) related to age (13; < 60 years of age, 10; 60 to 69 years, 7; 70 to 79 years, 6; ≥ 80 years of age). In patients over 80 years, survival was similar regardless of the treatment. Thirty‐day mortality varied from 2.5% to 20%, according to age groups. Conclusion The longer survival observed in patients with resection of the primary tumour may partly be explained by patient selection. Elderly patients (≥ 80 years) had a similar survival, irrespective of resection of the primary tumour or not. Careful consideration of the individual patient, extent of disease and treatment‐related factors are important in decision‐taking for palliative treatment for patients with advanced RC.