Surgical management of colorectal cancer in south-western Sydney 1997−2001: a prospective series of 1293 unselected cases from six public hospitals
S. K. Cyril Wong
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorA. Kneebone
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorMatthew Morgan
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorChristopher J. A. Henderson
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorAnn Morgan
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorBin Jalaludin
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorS. K. Cyril Wong
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorA. Kneebone
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorMatthew Morgan
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorChristopher J. A. Henderson
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorAnn Morgan
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorBin Jalaludin
* South Western Sydney Colorectal Tumour Group (SWSTG), Bankstown Hospital, † Collaboration for Cancer Outcomes Research and Evaluation (CCORE), Liverpool Hospital, ‡ Department of Anatomical Pathology, South Western Area Pathology Service (SWAPS), § Centre for Research, Evidence Management and Surveillance, South Western Sydney Area Health Service and ¶School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
Search for more papers by this authorS. K. C. Wong MB BS, FRACS, FRCSED; A. Kneebone MB BS, FRANZCR; M. Morgan MB BS, FRACS, MS; C. J. A. Henderson BSc, MB BS, FRCPA; A. Morgan BSc, MA, MPH; B. Jalaludin MB BS, PhD, FAFPHM.
Abstract
Background: The aim of the present study is to provide local data for the management of colorectal cancers in the south-western Sydney health area from 1997 to 2001.
Methods: The data were collected prospectively. Follow up was conducted in late 2001 and early 2002. Data were cross-validated with hospital and area databases and with data from the New South Wales Registry of Births, Deaths and Marriages.
Results: This was an unselected series of 1293 patients from 36 surgeons; 16.5% of patients presented as emergencies. Only 3% presented as a result of bowel cancer screening. Of the 1293 patients, 1270 received an operation. There were 598 elective colonic resections with the mortality rate of 1.2%, reoperation rate of 2.7% and anastomotic leak rate of 0.8%. For the 410 elective rectal resections, the rates were 2.9%, 2.7% and 1.2%, respectively. For the 290 emergency operations, the rates were much worse at 7.7%, 6.6% and 4.8%, respectively. The corrected overall 3-year survival rate was 64%. For Dukes’ A, B, C and D, the figures were 94%, 87%, 61% and 7%, respectively.
Conclusions: Colorectal cancer is a major cause of mortality and morbidity in our community. Very few bowel cancers were discovered at the asymptomatic stage. This paper strongly supports community bowel cancer screening and early diagnosis. The local database has provided a rich source of information to benchmark management and outcomes of bowel cancer patients treated in the South Western Sydney Area Health Service. An area-wide computer network with online data input facilities at individual workplaces will improve data integrity and data collection efficiency.
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