Guren Marianne G, Kørner Hartwig, Pfeffer Frank, Myklebust Tor Å, Eriksen Morten T, Edna Tom-Harald, Larsen Stein G, Knudsen Kristin O, Nesbakken Arild, Wasmuth Hans H, Vonen Barthold, Hofsli Eva, Færden Arne E, Brændengen Morten, Dahl Olav, Steigen Sonja E, Johansen Magnar J, Lindsetmo Rolv-Ole, Drolsum Anders, Tollåli Geir, Dørum Liv M, Møller Bjørn, Wibe Arne
a Department of Oncology , Oslo University Hospital , Oslo , Norway.
b K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital , Oslo , Norway.
Acta Oncol. 2015 Nov;54(10):1714-22. doi: 10.3109/0284186X.2015.1034876. Epub 2015 Apr 30.
The Norwegian Rectal Cancer Project was initated in 1993 with the aims of improving surgery, decreasing local recurrence rates, improving survival, and establishing a national rectal cancer registry. Here we present results from the Norwegian Colorectal Cancer Registry (NCCR) from 1993 to 2010.
A total of 15 193 patients were diagnosed with rectal cancer in Norway 1993-2010, and were registered with clinical data regarding diagnosis, treatment, locoregional recurrences and distant metastases. Of these, 10 796 with non-metastatic disease underwent tumour resection. The results were stratified into five time periods, and the treatment outcomes were compared. Recurrence rates are presented for the 9785 patients who underwent curative major resection (R0/R1).
Among all 15 193 patients, relative five-year survival increased from 54.1% in 1993-1997 to 63.4% in 2007-2010 (p < 0.001). Among the 10 796 patients with stage I-III disease who underwent tumour resection, from 1993-1997 to 2007-2010, relative five-year survival improved from 71.2% to 80.6% (p < 0.001). An increasing proportion of these patients underwent surgery at large-volume hospitals; and 30- and 100-day mortality rates, respectively, decreased from 3.0% to 1.4% (p < 0.001) and from 5.1% to 3.0% (p < 0.011). Use of preoperative chemoradiotherapy increased from 6.5% in 1993 to 39.0% in 2010 (p < 0.001). Estimated local recurrence rate after major resection (R0/R1) decreased from 14.5% in 1993-1997 to 5.0% in 2007-2009 (p < 0.001), and distant recurrence rate decreased from 26.0% to 20.2% (p < 0.001).
Long-term outcomes from a national population-based rectal cancer registry are presented. Improvements in rectal cancer treatment have led to decreased recurrence rates of 5% and increased survival on a national level.
挪威直肠癌项目始于1993年，旨在改进手术方式、降低局部复发率、提高生存率并建立全国直肠癌登记处。在此，我们展示了1993年至2010年挪威结直肠癌登记处（NCCR）的结果。
1993年至2010年期间，挪威共有15193例患者被诊断为直肠癌，并登记了有关诊断、治疗、局部区域复发和远处转移的临床数据。其中，10796例非转移性疾病患者接受了肿瘤切除术。结果被分为五个时间段，并对治疗结果进行了比较。给出了9785例行根治性大切除术（R0/R1）患者的复发率。
在所有15193例患者中，相对五年生存率从1993年至1997年的54.1%提高到2007年至2010年的63.4%（p<0.001）。在10796例I-III期疾病且接受肿瘤切除术的患者中，从1993年至1997年到2007年至2010年，相对五年生存率从71.2%提高到80.6%（p<0.001）。这些患者中，在大容量医院接受手术的比例增加；30天和100天死亡率分别从3.0%降至1.4%（p<0.001）和从5.1%降至3.0%（p<0.011）。术前放化疗的使用从1993年的6.5%增加到2010年的39.0%（p<0.001）。大切除术（R0/R1）后的估计局部复发率从1993年至1997年的14.5%降至2007年至2009年的5.0%（p<0.001），远处复发率从26.0%降至20.2%（p<0.001）。
展示了基于全国人群的直肠癌登记处的长期结果。直肠癌治疗的改进已使全国复发率降低至5%并提高了生存率。
