NEW YORK, Jul 12 (Reuters Health) - Video-based workshops conducted in
Stockholm in the mid-1990s taught surgeons a new procedure for rectal
cancer--and led to reduced cancer recurrence rates and better survival odds in
rectal cancer patients.
Rectal cancer responds favorably to radiation therapy given before surgery
is performed. Swedish researchers have found that the introduction of a specific
surgical technique combined with radiotherapy results in an impressive decrease
in recurrence rates.
"Workshops started in 1994 and included 11 television-based demonstrations
and two histopathology sessions" to teach surgeons the modified surgical
approach, Dr. A. Lehander Martling and colleagues of the Stockholm Colorectal
Cancer Study Group and the Basingstoke Bowel Cancer Research Project explain in
the July 8th issue of The Lancet.
Histopathology refers to the study of diseased tissue and in these sessions,
surgeons were given intensive training in the new procedure, called total
mesorectal excision, which aimed to improve the precision of surgery for rectal
cancer.
After analyzing surgeries and their outcomes for 447 patients in 1995-1996,
and comparing them with procedures performed prior to the introduction of the
new program, the researchers determined that the "initiative had a major effect
on cancer outcomes" including a decrease in cancer recurrence of more than 50%.
According to the study report, the decrease was not only limited to
recurrence of local disease. The percentage of major abdominal surgery
procedures dropped from 60% to 27%, which the authors attribute to several
factors including the new surgical technique.
Also, "the rate of early deaths due to rectal cancer was lower in
the...project group...(which) may be explained by a lower frequency of local
recurrence and by a lower frequency of distant metastases after local
recurrence," the team writes. That is, recurrences occurred less often but when
they did occur, the disease was less likely to have spread to other, more
distant areas of the body.
Continued follow-up of patients should yield additional information about
the true frequencies of recurrence in patients who underwent the new surgical
procedure, the study authors conclude.
