The results of surgical treatment for carcinoma of the rectum of St Mark's Hospital from 1948 to 1972

Abstract

The surgical treatment of 3163 patients seen at St Mark's Hospital with a single adenocarcinoma of the rectum in the years 1948-72 is described and the results analysed. In 2948 patients (93-2 per cent) the primary tumour was removed. The operative mortality fell from 7-0 per cent in the years 1948-52 to 2-1 per cent in 1968-72. The proportion of restorative operations has risen steadily over the years to a level of 41-1 per cent in the years 1968-72. There were 2410 operation survivors in the years 1948-67. The crude 5-year survival rate in the whole group was 47-1 per cent (corrected figure 56-7 per cent), and 56-6 per cent (corrected figure 68-4 per cent) for the 1931 survivors of radical operations. Comparison of results for patients surviving radical synchronous combined excision and radical anterior resection shows a significant difference in the two groups: in the former the crude 5-year survival rate was 52-7 per cent (corrected figure 63-8 per cent), and in the latter group the respective figures were 66-7 and 79-4 per cent. A higher proportion of Dukes' A and B cases and of low grade tumours are shown as the pathological background to the more favourable prognosis for patients surviving radical anterior resection.