Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993-2010
Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993-2010
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DOI：
10.3109/0284186x.2015.1034876
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发表时间：
2015-11-26
期刊：
影响因子：
3.1
通讯作者：
Wibe, Arne
中科院分区：
文献类型：
--
作者：
Guren, Marianne G.;Korner, Hartwig;Wibe, Arne
背景。挪威直肠癌项目于 1993 年启动，旨在改进手术、降低局部复发率、提高生存率并建立国家直肠癌登记处。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。材料和方法。 1993-2010年挪威共有15 193名患者被诊断为直肠癌，并登记了有关诊断、治疗、局部复发和远处转移的临床数据。其中，10 796 名非转移性疾病患者接受了肿瘤切除术。结果分为五个时间段，并对治疗结果进行比较。列出了 9785 名接受根治性大切除术 (R0/R1) 的患者的复发率。结果。在所有 15 193 名患者中，相对五年生存率从 1993-1997 年的 54.1% 增加到 2007-2010 年的 63.4%（p < 0.001）。从1993-1997年到2007-2010年，在10 796名接受肿瘤切除的I-III期疾病患者中，相对五年生存率从71.2%提高到80.6%（p < 0.001）。越来越多的患者在大型医院接受手术； 30 天和 100 天死亡率分别从 3.0% 下降至 1.4% (p < 0.001)，从 5.1% 下降至 3.0% (p < 0.011)。术前放化疗的使用率从 1993 年的 6.5% 增加到 2010 年的 39.0% (p < 0.001)。大切除后估计的局部复发率（R0/R1）从1993-1997年的14.5%下降到2007-2009年的5.0%（p < 0.001），远处复发率从26.0%下降到20.2%（p < 0.001）。结论。介绍了基于全国人口的直肠癌登记的长期结果。直肠癌治疗的改进使全国范围内的复发率降低了 5%，并提高了生存率。
Background. 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.Material and methods. 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).Results. 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).Conclusion. 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.