[Comparative study of oncological outcome quality in colorectal carcinoma--ranking by surrogate endpoint?]

The data of the German Prospective Multicenter Study of the Study Group Colorectal Carcinoma (SGCRC) were analyzed with regard to interinstitutional differences in 5-year survival by statistical methods adequate for ranking and observing anonymity. Furthermore, possible so-called surrogate endpoints that allow an assessment of definite outcome after surgical treatment earlier than after 5 years were also analyzed. This requires a separate analysis for rectal and colon carcinoma patients. For rectal carcinoma, the combination of the frequency of local tumor cell spillage during tumor resection (iatrogenous tumor perforation and/or incision into or through tumor tissue) and the rate of locoregional recurrences (within 2 years after surgery) could be demonstrated as reliable surrogate endpoint. For colon carcinoma, no reliable surrogate endpoint could be found. Surgical morbidity is not an indicator of definite outcome. A very low rate of surgical mortality does not ensure satisfactory long-term results in colorectal cancer surgery.