Department of Colorectal Surgery, Maidstone and Tunbridge Wells NHS Trust, UK.
Int J Surg. 2018 Jul;55:152-155. doi: 10.1016/j.ijsu.2018.05.731. Epub 2018 May 30.
Colorectal cancer is a major cause of illness, disability and death in the United Kingdom. The stage of disease at diagnosis has a major impact on survival rates. The aim of this study is to assess whether the survival rates of patients receiving curative treatment in our centre are comparable with national results published by Cancer Research UK, National Bowel Cancer Audit Annual Report 2016, and NCIN Colorectal Cancer Survival by Stage Data Briefing.
The study involved a retrospective survival analysis of consecutive patients who underwent colorectal cancer resections with curative intent performed by two surgeons between January 2009 and March 2012. Patients were identified from a prospectively collected database. Data was collected via hospital computer systems including patient notes, laboratory, pathology, and radiology systems. Exclusion criteria included all patients with advanced disease who underwent surgery with palliative intent.
A total of 281 patients were included. The median age at operation was 71. Overall 2-year survival was 82.6% and overall 5-year survival was 69%. 2-year and 5-year survival, respectively, for Dukes A was 93.7% and 92%, Dukes B was 85.6% and 76.7%, Dukes C1 was 81.1% and 57.8%, Dukes C2 was 56.3% and 25%, and Dukes D was 61.9% and 47.6%.
Our data demonstrates that our survival rates compare favourably with current published national survival rates. Dukes C2 patients had the poorest five year survival, highlighting the significance of a positive apical node. Dukes D patients had a particularly good outcome which indicates good patient selection by the multi-disciplinary meeting (MDT) and high quality oncology and tertiary surgical support.
结直肠癌是英国导致疾病、残疾和死亡的主要原因。诊断时的疾病分期对生存率有重大影响。本研究旨在评估在我们中心接受根治性治疗的患者的生存率是否与英国癌症研究中心(Cancer Research UK)、国家肠癌审计年度报告(National Bowel Cancer Audit Annual Report)2016 年和国家癌症研究所(NCIN)结直肠癌分期数据简报公布的全国结果相媲美。
这项研究涉及对 2009 年 1 月至 2012 年 3 月期间由两位外科医生进行的具有根治性意图的连续结直肠癌切除术患者进行回顾性生存分析。从一个前瞻性收集的数据库中识别出患者。通过医院计算机系统(包括患者病历、实验室、病理学和放射学系统)收集数据。排除标准包括所有接受姑息性手术的晚期疾病患者。
共纳入 281 例患者。手术时的中位年龄为 71 岁。总的 2 年生存率为 82.6%,总的 5 年生存率为 69%。Dukes A 的 2 年和 5 年生存率分别为 93.7%和 92%,Dukes B 为 85.6%和 76.7%,Dukes C1 为 81.1%和 57.8%,Dukes C2 为 56.3%和 25%,Dukes D 为 61.9%和 47.6%。
我们的数据表明,我们的生存率与当前公布的全国生存率相比表现良好。Dukes C2 患者的五年生存率最差,突出了阳性顶结节的重要性。Dukes D 患者的预后特别好,这表明多学科会议(MDT)的患者选择良好,以及高质量的肿瘤学和三级手术支持。