Journal of Applied Medical Sciences

A retrospective study of survival and recurrence in patients undergoing resection for sigmoid and rectal cancer to compare local rates to published data

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• Abstract

  Colorectal cancer is the third most common malignant tumor throughout the Western world. Rectal cancer comprises approximately one third of the cases. In this retrospective cohort study, we report the survival and recurrence in patients undergoing sigmoid and rectal cancer (CRC) resections at a large UK South Coast colorectal unit and compare our local rates to the published data. Patients undergoing sigmoid and rectal cancer resections between Jan 2010 and Dec 2012 were eligible (n=263). Recurrence data was taken from local colorectal Multi-Disciplinary-Meeting (MDM) reports and mortality data from local MDM records and the hospital patient administration system. Mortality was recorded up to 15/01/2016, and recurrence up to last MDM discussion. Operative details were taken from procedure descriptions on theatre databases.222 patients were eligible for analysis. 79 (35.59%) underwent sigmoid colectomy and 143 (64.41%) anterior resection of rectal cancer. 33 patients (14.93%) had recurrence of cancer. Total 30 day mortality for confirmed CRC patients was 1.80% (n=4), and total 3 year mortality was 13.96% (n=31). 5-year mortality data was available for 78 patients, with survival of 70.5%. Cox proportional hazards modelling revealed impaired survival with increasing age (HR 1.05, 95% CI 1.02-1.08, p=0.002), emergency admission (HR 9.31, 3.44-25.16, p<0.001), and recurrence of cancer (HR 9.16, 4.96-16.94, p<0.001).30-day mortality and recurrence at our centre is broadly in line with existing published data, with subgroup analysis of patients with 5-year data demonstrating improved survival.