Patterns of care for European colorectal cancer patients diagnosed 1996-1998: A EUROCARE High Resolution Study
Patterns of care for European colorectal cancer patients diagnosed 1996-1998: A EUROCARE High Resolution Study
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DOI：
10.3109/02841861003782009
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发表时间：
2010-08-01
期刊：
影响因子：
3.1
通讯作者：
Faivre, Jean
中科院分区：
文献类型：
--
作者：
Gatta, Gemma;Zigon, Giulia;Faivre, Jean
目标。通过评估参与EUROCARE的12个欧洲癌症登记处（CR）的基于人群的信息，以及从个人临床记录中获得的额外信息，确定欧洲结直肠癌管理的差异。方法与患者。我们考虑了五个指标：(a)有治疗目的的切除；(b)术后死亡率；(c) II/III期结肠癌患者给予辅助化疗的比例；(d)接受放疗的直肠癌病例比例；(e)检查了12个或更多淋巴结的治愈性切除的比例。结果。在1996年至1998年期间确诊的6 871名结直肠癌患者接受了检查。总体而言，71%的患者接受了有治愈意图的切除，CR范围为44-86%；46%的III期结肠癌患者（CR范围24-73%）和22%的II期患者（当时不推荐）接受了辅助化疗；12%的直肠癌患者接受了辅助放疗，两次cr的范围为51%。只有29%的治疗目的切除检查了12个或更多的淋巴结。结论。这项研究表明，尽管大多数患者接受手术治疗的目的是治愈，但在20世纪90年代末，欧洲结直肠癌治疗的差异出乎意料地大，许多患者没有接受已发表的临床试验所指示的治疗。关于结直肠癌管理的协商一致的指导方针现在已经可以获得，应该在整个欧洲采用。人们希望，指南的传播将改善对该疾病的科学证明的治疗方法的使用，但这应通过进一步的基于人群的研究来监测。
Objective. To identify disparities in the management of colon and rectal cancer across Europe by assessing population-based information from 12 European cancer registries (CR) participating in EUROCARE, together with additional information obtained from individual clinical records. Methods and patients. We considered five indicators: (a) resection with curative intent; (b) post-operative mortality; (c) proportion of stage II/III colon cancer cases given adjuvant chemotherapy; (d) proportion of rectal cancer cases receiving radiotherapy; and (e) proportion of curative intent resections with 12 or more lymph nodes examined. Results. A total of 6 871 colorectal cancer patients, diagnosed between 1996-1998, were examined. Overall 71% of patients received resection with curative intent, range 44-86% by CR; 46% of stage III colon cancer cases (range 24-73% by CR) and 22% of stage II cases (not then recommended) received adjuvant chemotherapy; 12% of rectal cancer cases received adjuvant radiotherapy, range 51% in two CRs. For only 29% of curative intent resections were 12 or more lymph nodes examined. Conclusions. This study reveals that, although most patients received surgery with curative intent, disparities in treatment for colorectal cancer across Europe in the late 1990s were unexpectedly large, with many patients not receiving treatments indicated by published clinical trials. Consensus guidelines for CRC management are now becoming available and should be adopted across Europe. It is hoped that dissemination of guidelines will improve the use of scientifically proven treatments for the disease, but this should be monitored by further population-based studies.