TREATMENT OF RECTAL-CANCER IN FRANCE - A POPULATION-BASED STUDY

Objectives and methods. - Therapeutic modalities in rectal cancer were analyzed in a French population based study. This work reviewed all the new cases of rectal adenocarcinoma diagnosed in a one-year period from January ist to December 31st 1990 among the population of 7 provinces. Thus, 427 new cases of rectal cancer were included in a data base (EUROCARE). The main goal of this study was to provide an up-to-date, unbiased evaluation of the different treatments of rectal cancer according to ifs stage when diagnosed. The aim was also to point out differences in therapeutic management between these different geographic areas. A three-stage clinico-pathological staging was used to minimize stage migration bias. Results. - 77,8 % of the patients underwent a rectal excision; among them, 53,9 % had a sphincter saving procedure. Adjuvant radiotherapy was associated to rectal resection in 46,2 % of the patients and was pre-operative in 45,9 %. Only 13,7 % of patients had chemotherapy. Conclusions. - We demonstrated a significative difference of therapeutic modalities between these different french geographic areas concerning adjuvant radiotherapy and chemotherapy. This work supports the need and the value of population-based study for clinical management, prognostic evaluation and evaluation of public health issues.