Aim: The aim was to study the effects of the introduction of TME surgery and pre-operative radiotherapy on overall survival (OS) by comparing patients treated in the period before (1990-1995), during (1996-1999) and after (2000-2002) the TME trial. Patients and methods: Patients diagnosed with rectal carcinoma in the region of Comprehensive Cancer Centres South and West were used (n = 3179). Results: Five-year OS was, respectively, 56%, 62% and 65% in the pre-trial, trial and post-trial periods (p < 0.001). Pre-operative RT was increasingly used over time and significantly related to OS in the post-trial period (p = 0.002), but not in the pre-trial and trial periods. Conclusions: Population-based OS improved markedly since the introduction of TME surgery. With standardised TME surgery, pre-operative RT improved OS, whereas withholding pre-operative RT was associated with a poorer prognosis. The present study supports that pre-operative RT was correctly introduced as a standard treatment before TME surgery in our national guideline.

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Keywords (neo)Adjuvant treatment, Overall survival, Quality assurance, Rectal cancer, Total mesorectal excision (TME), Training
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Journal European Journal of Cancer
den Dulk, M, Krijnen, P, Marijnen, C.A.M, Rutten, H.J.T, van de Poll-Franse, L.V, Putter, H, … van de Velde, C.J.H. (2008). Improved overall survival for patients with rectal cancer since 1990: The effects of TME surgery and pre-operative radiotherapy. European Journal of Cancer, 44(12), 1710–1716. doi:10.1016/j.ejca.2008.05.004