Abstract
The surgical treatment of 3163 patients seen at St Mark's Hospital with a single adenocarcinoma of the rectum in the years 1948β72 is described and the results analysed.
In 2948 patients (93Β·2 per cent) the primary tumour was removed. The operative mortality fell from 7Β·0 per cent in the years 1948β52 to 2Β·1 per cent in 1968β72. The proportion of restorative operations has risen steadily over the years to a level of 41Β·1 per cent in the years 1968β72.
There were 2410 operation survivors in the years 1948β67, The crude 5-year survival rate in the whole group was 47Β·1 per cent (corrected figure 56Β·7 per cent), and 56Β·6 per cent (corrected figure 68Β·4 per cent) for the 1931 survivors of radical operations.
Comparison of results for patients surviving radical synchronous combined excision and radical anterior resection shows a significant difference in the two groups: in the former the crude 5-year survival rate was 52Β·7 per cent (corrected figure 63Β·8 per cent), and in the latter group the respective figures were 66Β·7 and 79Β·4 per cent. A higher proportion of Dukes' A and B cases and of low grade tumours are shown as the pathological background to the more favourable prognosis for patients surviving radical anterior resection.