COLORECTAL-CANCER - A CONTINUING PROBLEM

Outcome in 645 patients presenting with colorectal cancer between 1974 -9 and a subsequent cohort of 483 patients presenting between 1980-4 w as compared, During both periods studied, approximately one third of p atients presented as emergencies, over one third had clinical evidence of local tumour fixity at the time of initial presentation and approx imately one quarter had distant metastases. Approximately 80% of patie nts presenting electively underwent resection; postoperative mortality was approximately 10%. Resection rates were lower and postoperative m ortality higher in the elderly and those presenting as emergencies, Ov erall survival at five years was 31% for patients undergoing elective surgery and 12% for those presenting as emergencies. Despite the impro vements in surgery and peri-operative care, no significant differences in outcome were noted between the two periods studied. This is probab ly a reflection of the high proportion of patients who present as emer gencies and the advanced stage of the disease at the time of initial p resentation.