A multicentre retrospective audit of outcome of patients undergoing curative resection for rectal cancer

This study describes the outcome of patients with rectal cancer treated in four New Zealand public hospitals before the advent of specialised colorectal units in order to provide a baseline against which any changes in management can be measured.

A retrospective review of case notes of patients who underwent resection of rectal cancer with curative intent over a period of 7-10 years up to 1995 in Christchurch, Wellington, Nelson, and Masterton Public Hospital's, was undertaken. Patients were identified from hospital records using a combination of methods (pathology data bases, clinical case mix data, operating logs and audit data). Metastatic disease was considered to be present if confirmed on histology or the clinical course of the patient was consistent with metastatic disease. Patients were excluded if there was perioperative evidence of metastatic disease or if they had transanal excision. Previously published results from Auckland and Dunedin Hospitals are compared.

524 patients with rectal cancer were identified who had undergone surgery with curative intent in the four hospitals. The overall permanent stoma rate was 37%. The overall 30-day mortality was 2.9%, five-year survival was 63% and local recurrence at five years was 26%.

While low perioperative mortality and good long-term survival were achieved, there were high rates of local recurrence. These data are a baseline against which the impact of new approaches to curative resection for rectal cancer can be measured.