Management of rectal cancers in relation to treatment guidelines: A population-based study comparing Italian and French patients

Pamela Minicozzi, Anne Marie Bouvier, Jean Faivre, Milena Sant, M. Velten, G. Launoy, V. Bouvier, J. Faivre, A. M. Bouvier, A. S. Woronoff, M. Robaszkiewicz, A. Buémi, B. Trétarre, M. Colonna, P. Delafosse, F. Molinié, S. Bara, P. Grosclaude, M. Sant, P. MinicozziC. Allemani, S. Kaleci, S. Maffei, M. Ponz de Leon, A. Giacomin, E. Crocetti, A. Caldarella, M. Federico, F. Iachetta, M. Fusco, R. Tumino, L. Mangone, M. Vicentini, P. Giorgi Rossi, F. Falcini, M. Budroni, R. Cesaraccio

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Few studies have investigated rectal cancer management at the population level. We compared how rectal cancers diagnosed in Italy (2003-2005) and France (2005) were managed, and evaluated the extent to which management adhered to European guidelines. Methods: Samples of 3938 Italian and 2287 French colorectal cancer patients were randomly extracted from 8 and 12 cancer registries respectively. Rectal cancer patients (860 Italian, 559 French) were analysed. Logistic regression models estimated odds ratios (ORs) of being treated with curative intent, receiving sphincter-saving surgery, and receiving preoperative radiotherapy. Results: Similar proportions of Italian and French patients were treated with curative intent (70% vs. 67%; OR = 0.92 [0.73-1.16]); the respective proportions receiving sphincter-saving surgery were 21% and 33% (OR = 1.15 [0.86-1.53]). In about 50% of those treated with curative intent, ≥12 lymph nodes were harvested in both countries. The proportion receiving postoperative radiotherapy was higher in Italy than in France (25% vs. 11%, p<0.01), but French patients were more likely to receive preoperative radiotherapy (52% vs. 21%; OR = 4.06 [2.79-5.91]). Conclusion: The proportions of patients receiving preoperative radiotherapy and the numbers of lymph nodes sampled were low in both countries. Centralising treatment and potentiating screening would be practical ways of improving outcomes and adhering to guidelines.

Original languageEnglish
Pages (from-to)645-651
Number of pages7
JournalDigestive and Liver Disease
Volume46
Issue number7
DOIs
Publication statusPublished - 2014

Keywords

  • Cancer registry
  • Management
  • Rectal cancer

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

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