Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993–2010

Authors

  • Marianne G. Guren Department of Oncology, Oslo University Hospital, Oslo, Norway; K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway
  • Hartwig Kørner Department of GI Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway
  • Frank Pfeffer Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Surgery, Haukeland University Hospital, Bergen, Norway
  • Tor Å. Myklebust Department of Registration, Cancer Registry of Norway, Oslo, Norway
  • Morten T. Eriksen Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
  • Tom-Harald Edna Department of Surgery, Levanger Hospital, North-Trondelag Hospital Trust, Levanger, Norway; Unit for Applied Clinical Research, Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
  • Stein G. Larsen Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway
  • Kristin O. Knudsen Department of Registration, Cancer Registry of Norway, Oslo, Norway
  • Arild Nesbakken K. G. Jebsen Colorectal Cancer Research Centre, Oslo University Hospital, Oslo, Norway; Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Centre for Cancer Biomedicine, University of Oslo, Oslo, Norway
  • Hans H. Wasmuth Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
  • Barthold Vonen Nordland Hospital Trust, Bodø, Norway; University of Tromsø, Institute of Community Medicine, Tromsø, Norway
  • Eva Hofsli Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
  • Arne E. Færden Department of Digestive Surgery, Akershus University Hospital, Lørenskog, Norway
  • Morten Brændengen Department of Oncology, Oslo University Hospital, Oslo, Norway
  • Olav Dahl Department of Clinical Science, MOF, University of Bergen, Bergen, Norway; Department of Oncology, Haukeland University Hospital, Bergen, Norway
  • Sonja E. Steigen Department of Pathology, University Hospital of North Norway, Tromsø, Norway
  • Magnar J. Johansen Department of Oncology, University Hospital of North Norway, Tromsø, Norway
  • Rolv-Ole Lindsetmo Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway; Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
  • Anders Drolsum Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
  • Geir Tollåli Department of Gastroenterology, Nordland Hospital, Bodø, Norway
  • Liv M. Dørum Department of Registration, Cancer Registry of Norway, Oslo, Norway
  • Bjørn Møller Department of Registration, Cancer Registry of Norway, Oslo, Norway
  • Arne Wibe Department of Gastrointestinal Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway

DOI:

https://doi.org/10.3109/0284186X.2015.1034876

Abstract

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.

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Published

2015-11-26

How to Cite

Guren, M. G., Kørner, H., Pfeffer, F., Myklebust, T. Å., Eriksen, M. T., Edna, T.-H., … Wibe, A. (2015). Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993–2010. Acta Oncologica, 54(10), 1714–1722. https://doi.org/10.3109/0284186X.2015.1034876

Issue

Vol. 54 No. 10 (2015): Acta Oncologica

Section

Articles