Colorectal carcinoma—Trends and results over a 30-year period

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Abstract
The experience of Karolinska Hospital, Stockholm, Sweden, with colorectal carcinoma over a 30 yr period, 1950-1979, was reviewed and analyzed. Altogether, 1061 patients were seen; 69% were resected with the intention of cure. The proportion of curative resections did not change with time. Operative mortality deceased from 12 to slightly over 1%. Five yr survival rates were 34% overall and 47% in curable cases. After correction for operative mortality, the latter rate increased from 47 to 58% over the study period (no signiicance). Sex and age were not correlated with survival. Of tumors resected for cure, 28% were Dukes'' A, 39% Dukes'' B and 33% Dukes'' C. Corresponding 5-yr survival rates were 82, 44 and 21%. Though the proportion of Dukes'' A tumors increased from 23 to 33% over the 30 yr interval, the impact on overall prognosis was insignificant. A possible overdiagnosis of Dukes'' A is discussed. The proportion of sphincter-saving procedures for rectal carcinoma increased moderately; excisional and restorative procedures were equal with respect to mortality and survival. Some patients underwent local excisions for Dukes'' A rectal carcinomas with a close to 90% 5 yr survival.