Assessment of management practices for colonic cancer in the Paris metropolitan area in 2002

To assess the management of patients aged 18 years or older with colonic adenocarcinoma (including the rectosigmoid junction), compared with French guidelines (ANAES and SOR).

This retrospective study carried out in 2003 by the Ile-de-France regional union of health insurance funds from hospital discharge and operative and pathology reports of patients exempted from copayment between April 2001 and March 2002.

In all, 1 842 patients were included; mean age was 68.7 +/- 12.7 years and the M/F ratio was 1.09. 17.3% of patients were diagnosed after complications (obstruction, perforation); 25.1% had synchronous metastases, 79.7% with at least one liver metastasis. Serum CEA assay was performed in 50.0% of patients, in combination with CA 19-9 in 31.1% of patients. In 24.9%, less than 8 lymph nodes were analyzed. 37.7% of stage II patients had chemotherapy while 10.8% of stage III and 9.8% of stage IV patients did not. Age was a determining factor in the decision of chemotherapy (P<0.0001).

Implementation of guidelines for the management of colon cancer can be improved, notably regarding pathologic analysis and indications of chemotherapy.