Abstract
Introduction
The aim of this EURECCA international comparison is to compare oncologic treatment
strategies and relative survival of patients with stage I–III rectal cancer between
European countries.
Material and methods
Population-based national cohort data from the Netherlands (NL), Belgium (BE), Denmark
(DK), Sweden (SE), England (ENG), Ireland (IE), Spain (ES), and single-centre data
from Lithuania (LT) were obtained. All operated patients with (y)pTNM stage I-III
rectal cancer diagnosed between 2004 and 2009 were included. Oncologic treatment strategies
and relative survival were calculated and compared between neighbouring countries.
Results
We included 57,120 patients. Treatment strategies differed between NL and BE (p < 0.001),
DK and SE (p < 0.001), and ENG and IE (p < 0.001). More preoperative radiotherapy
as single treatment before surgery was administered in NL compared with BE (59.7%
vs. 13.1%), in SE compared with DK (55.1% vs. 10.4%), and in ENG compared with IE
(15.2% vs. 9.6%). Less postoperative chemotherapy was given in NL (9.6% vs. 39.1%),
in SE (7.9% vs. 14.1%), and in IE (12.6% vs. 18.5%) compared with their neighbouring
country. In ES, 55.1% of patients received preoperative chemoradiation and 62.3% postoperative
chemotherapy. There were no significant differences in relative survival between neighbouring
countries.
Conclusion
Large differences in oncologic treatment strategies for patients with (y)pTNM I-III
rectal cancer were observed across European countries. No clear relation between oncologic
treatment strategies and relative survival was observed. Further research into selection
criteria for specific treatments could eventually lead to individualised and optimal
treatment for patients with non-metastasised rectal cancer.
Keywords
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Article info
Publication history
Published online: May 26, 2018
Accepted:
May 17,
2018
Footnotes
☆Presentations: Presented in part at the 34th European Society of Surgical Oncology Congress, 29–31 October 2014, Liverpool. Partly presented as a poster presentation at the 18th ECCO – 40th ESMO European Cancer Congress, 25–29 September 2015, Vienna.
Identification
Copyright
© 2018 Published by Elsevier Ltd.
