A 10-year prospective audit of outcome of surgical treatment for colorectal carcinoma

Abstract

The outcome of 555 patients who underwent surgery under the care of a surgeon with an interest in colorectal disease was examined prospectively over a 10-year period with no exclusions. There was a 4.7 per cent incidence of clinical leaks (10 per cent for anterior resection) and an overall corrected 10-year survival rate after curative surgery of 58, 59 and 48 per cent for right colonic, left colonic and rectal tumours respectively. The incidence of isolated local recurrence was 8 per cent after curative surgery for carcinoma of the rectum. Twenty-five per cent of patients with rectal tumours required abdominoperineal excision. Patients who underwent curative abdominoperineal excision of the rectum had corrected 5-and 10-year survival rates of 48 and 36 per cent, compared with 60 and 58 per cent respectively for curative anterior resection. The perioperative mortality rate of those undergoing palliative surgery was 8 per cent, and 75 per cent died within 2 years from distant and not local disease. A policy of always attempting resection was validated by the fact that 99 per cent of primary tumours were removed with a low perioperative mortality rate (4 per cent overall), a high curative resection rate and a low morbidity rate.