European Colorectal Cancer Management: Implemented as it is or Adapted to our National Specificity

Abstract

Objective: We attempt to evaluate how the European treatment guides are implemented in a clinic hospital in Targu Mures and if those rules could be adopted as they are or must be adapted to our national specificity. Methods: For a number of 441 patients included in the study, the electronic prospectively maintained archive of 3rd Surgery was interrogated for: age, preoperative colonoscopy, postoperative colonoscopies, chemo-radiotherapy enrollment, stage of the disease, type of surgery. Local and regional relapses were assessed and their incidence was related to type of surgery. Survival analysis was done in a simplified manner and differentiated for age below and above 75 years. Results: Patient's age distribution revealed a deviation to the right compared with a normal distribution with a median off 64.76±11.47. Colonoscopy was done in only 65 cases, exclusive preoperatively. Chemoradiotherapy was administered in 168 cases, only 12 of them initiated preoperatively. The type of surgery performed was found positively correlate with the stage of the disease. The survival probability for the patients in this study showed a 50% survival rate at 1 year and only 2% at 5 years. Conclusions: Passive screening age in CRC should be decreased to 55 years. Stage 3 and 4 of disease for CRC are over 70% of cases, like 20 years ago. Survival rate in CRC is far lower than other studies. Integrated CRC management and European practical guides are still "in wishing" stage.