Background: Between 1985 and 1989, only one centre in Sweden combined preoperative radiotherapy with total mesorectal excision (TME) in the primary treatment of rectal cancer. The aim of this study was to investigate whether this change in primary treatment had an impact on the outcome.
Method: The survival rate of 94,262 patients with colorectal cancer from the total Swedish population between 1960 and 1989 was analysed.
Results: A continuous improvement in relative survival rate occurred during the first year of follow-up for both colonic and rectal cancer. Some improvement was also seen during follow-up years 2-5, but this was much more pronounced during the last period (1985-1989) for rectal cancer in the county of Uppsala. The improvement was particularly marked during follow-up years 3-5.
Conclusion: There are strong indications from this study that altered primary treatment for rectal cancer results in improved long-term survival.