The Grapevine

Surgery To Treat Stage 4 Colorectal Cancer Is Becoming Less Common, But Survival Rates Are Increasing

Cancer Surgery
Colon cancer patients are getting less surgery and surviving longer. Photo courtesy of Shutterstock

When it comes to cancer, surgery can be used for a number of reasons, including prevention, diagnostic, and curative. A recent study conducted at the University of Texas MD Anderson Center in Houston has revealed that the rate of patients undergoing surgery to treat colorectal cancer has dropped in the past two decades while the rate of survival has doubled.

According to the American Cancer Society, surgery, including colectomy, segmental resection, low anterior resection, and proctectomy with colo-anal anastomosis, is considered the main treatment for early colorectal cancer. Most forms of surgical intervention tend to involve removing the piece of the colon or rectum with the tumor and sewing the ends back together.

"Despite the availability of more effective chemotherapeutic options, a considerable number of patients with stage IV CRC continue to undergo PTR,” the authors said in a statement. “Our findings indicate potential overuse of PTR among these patients and highlight a need to better understand the clinical decisions and outcomes associated with that treatment.”

Lead researcher Dr. Chung-Yuan Hu and his colleagues used the National Cancer Institute’s Surveillance, Epidemiology, and End Results CRC registry to analyze patterns of primary tumor resection (PTR) and survival rates in stage IV colorectal cancer in the United States. The data sample included 64,157 patients who were diagnosed with stage IV colon or rectal cancer between 1988 and 2010. This included 43,273 patients who underwent PTR and those who did not.

Over the course of 22 years, the annual rate of PTR dropped from 74.5 percent in 1988 to 57.4 percent in 2010. Researchers linked this drop in PTR rates to the availability of newer chemotherapy and targeted treatments. While the PTR rate declined, the survival rate for stage IV colorectal cancer doubled from 8.6 percent in 1988 to 17.8 percent in 2009. Patients who did undergo PTR were generally under the age of 50, female, married, had a higher tumor grade, and had colon tumors.

Colorectal cancer refers to cancer that originates in either the colon or the rectum. Around 93,090 new cases of colon cancer, 39,610 new cases of rectal cancer, and 49,700 deaths from colorectal cancer are expected for 2015 in the U.S. Colorectal cancer is considered the third most common form of cancer found in men and women, not counting skin cancers. The overall lifetime risk for developing colorectal cancer is around one in 20.

Source: You N, Bailey C, Hu C, et al. Time Trend Analysis of Primary Tumor Resection for Stage IV Colorectal CancerLess Surgery, Improved Survival. JAMA Surgery. 2015. 

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