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  • Kodeda, KarlGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery (author)

Time trends, improvements and national auditing of rectal cancer management over an 18-year period

  • Article/chapterEnglish2015

Publisher, publication year, extent ...

  • 2015-08-08
  • Wiley,2015
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-261935
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-261935URI
  • https://doi.org/10.1111/codi.13060DOI
  • https://lup.lub.lu.se/record/7745685URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-108126URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:131782514URI
  • https://gup.ub.gu.se/publication/222127URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Aim: The main aims were to explore time trends in the management and outcome of patients with rectal cancer in a national cohort and to evaluate the possible impact of national auditing on overall outcomes. A secondary aim was to provide population-based data for appraisal of external validity in selected patient series.Method: Data from the Swedish ColoRectal Cancer Registry with virtually complete national coverage were utilized in this cohort study on 29925 patients with rectal cancer diagnosed between 1995 and 2012. Of eligible patients, nine were excluded.Results: During the study period, overall, relative and disease-free survival increased. Postoperative mortality after 30 and 90days decreased to 1.7% and 2.9%. The 5-year local recurrence rate dropped to 5.0%. Resection margins improved, as did peri-operative blood loss despite more multivisceral resections being performed. Fewer patients underwent palliative resection and the proportion of non-operated patients increased. The proportions of temporary and permanent stoma formation increased. Preoperative radiotherapy and chemoradiotherapy became more common as did multidisciplinary team conferences. Variability in rectal cancer management between healthcare regions diminished over time when new aspects of patient care were audited.Conclusion: There have been substantial changes over time in the management of patients with rectal cancer, reflected in improved outcome. Much indirect evidence indicates that auditing matters, but without a control group it is not possible to draw firm conclusions regarding the possible impact of a quality control registry on faster shifts in time trends, decreased variability and improvements. Registry data were made available for reference.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Johansson, RobertUmeå universitet,Onkologi(Swepub:umu)rojo0001 (author)
  • Zar, N. (author)
  • Birgisson, HelgiUppsala universitet,Kolorektalkirurgi(Swepub:uu)hebir255 (author)
  • Dahlberg, M.Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap (author)
  • Skullman, S. (author)
  • Lindmark, GudrunLund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,Surgery,Lund University Research Groups(Swepub:lu)med-gli (author)
  • Glimelius, BengtUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)bengglim (author)
  • Påhlman, LarsUppsala universitet,Kolorektalkirurgi(Swepub:uu)larspahl (author)
  • Martling, A.Karolinska Institutet (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för kirurgi (creator_code:org_t)

Related titles

  • In:Colorectal Disease: Wiley17:9, s. O168-O1791462-89101463-1318

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