Background:: Little is known about the management of recurrences from colorectal cancer at a population level. Materials and methods:: Data was obtained from the population-based cancer registry of Côte d'Or (Burgundy, France) over a 28-year period. Univariate and multivariate analyses were performed to analyse trends in treatment and survival for local recurrence and distant metastases. Results:: The proportion of patients resected for cure increased from 6.7% (1976–1984) to 23.7% (1994–2003; P <0.001) for distant metastases and from 15.9% to 58.1% (P <0.001) for local recurrence. Age and period of diagnosis were independent factors associated with a resection for cure. Rectal cancer local recurrence was less often resected for cure than colon cancer local recurrence (P=0.05). Long-term survival was observed only after resection for cure: 5-year relative survival rates were 36.1% for local recurrence and 24.0% for distant metastases. In the multivariate analysis, survival decreased with age and increased over time but significantly only over the last study period. Surgical resection and palliative chemotherapy were other determinants of prognosis for distant metastases whereas surgical resection and palliative radiotherapy did influence the prognosis for local recurrence. Conclusion:: Substantial advances in the management of recurrences have been achieved over time. More effective treatments and mass screening represent promising approaches to decrease this problem.

Colorectal cancer remains a major health problem in Europe, as in many areas of the world. It has been estimated that in 2018 in France, approximately 44 000 individuals were newly diagnosed with colorectal cancer, and 17 000 died of the disease.¹ In spite of mass screening programs deployed since the 2000s, the proportion of patients diagnosed with a metastatic tumor has ranged from 20% to 30% in European countries.^2,3 Although the liver is the main site for distant metastases in colorectal cancer, little is known about the incidence of synchronous liver metastases.

Ce, between the years 1976 and 2000. Results: Obstructing cancers represented 8.3 percent of all colorectal cancers. This proportion was stable throughout the study. Resection for cure increased from 54.9 percent (1976-1980) to 71.4 percent (1996-2000;P= 0.011). Using multivariate analysis, site of cancer and period of diagnosis were the only factors significantly associated to a curative resection. Postoperative mortality for obstructing colorectal cancers decreased from 32.6 percent (1976-80) to 15.2 percent (1996-2000;P< 0.001). The presence of obstruction was significantly associated with a higher postoperative mortality, independent of age and tumor stage (odds ratio = 2.55; 95 percent confidence interval = 2.13-3.5). Conclusion: The frequency of obstructing colorectal cancers has remained unchanged for 25 years. Operative mortality is still high, although some improvements have occurred. Efforts must be made to diagnose colorectal cancers before obstruction occurs. Mass screening represents a promising approach. Supported by a grant from the French Ligue Against Cancer (Saône-et-Loire Committee). e-mail: Anne-Marie.Bouvier@u-bourgogne.fr © The ASCRS 2007...

Background: The aim of this population-based study was to report on the incidence, treatment and prognosis of synchronous colorectal carcinomas. Methods: Data were obtained from the population-based cancer registry of Burgundy. Results: Between 1976 and 2004, 15 562 colorectal cancers were diagnosed. Some 3·8 per cent of patients had synchronous colorectal cancers. The risk of having synchronous cancers was higher in men (odds ratio (OR) 1·41 (95 per cent confidence interval (c.i.) 1·19 to 1·68)), when associated adenomas were present (OR 2·02 (95 per cent c.i. 1·69 to 2·41)), when there were adenomatous remnants on pathological examination (OR 2·10 (95 per cent c.i. 1·73 to 2·55)) and in patients aged over 75 years (OR 1·31 (95 per cent c.i. 1·08 to 1·59)). Synchronous tumours were more often located on the same intestinal segment, although the correlation was weak (κ = 0·26). Resection for cure was performed in 74·8 per cent of synchronous cancers and 72·0 per cent of single cancers (P = 0·131). Five-year relative survival for synchronous (48·7 per cent) and single (48·3 per cent) cancers was almost identical. Stage, age, associated adenomas and adenomatous remnants were independent prognostic factors. Conclusion: Synchronous colorectal cancers convey a similar prognosis to single tumours. Men and patients aged over 65 years with associated adenomas are more prone to multiple colorectal cancers.

Pancreatic cancer is one of the most lethal. Most countries have exhibited a stable or decreasing incidence over time. The aim of this study was to provide updated French temporal trends in pancreatic cancer incidence and mortality over the past three decades. Incidence was estimated using the French National Network of Cancer Registries (FRANCIM) and mortality using the French Mortality Statistics Office. World age-standardized incidence and mortality were modelled by age-period-cohort models. The net cumulative risk of developing pancreatic cancer by birth cohort was calculated, as were annual percentage changes (APCs) in incidence and mortality. Between 1982 and 2012, age-standardized incidence increased from 4.8 in 1980 to 9.6 per 100 000 in men and from 2.3 to 6.8 in women. The mean APC was 2.3% (2.1–2.6) and 3.6% (3.3–3.9), respectively. The cumulative risk of developing pancreatic cancer before age 75 rose from 0.62% for males born around 1920 to 1.17% for those born around 1950. It was respectively 0.31% and 0.86% for women. Mortality did not vary in men (8.1 per 100 000). It slightly increased in women from 4.0 in 1982 to 5.4 in 2012. Pancreatic cancer incidence and mortality exhibited diverging trends. Incidence increased over the last 30 years in France whereas mortality did not vary in men and moderately increased in women. Incidence remained lower than mortality up to 2002. One cannot exclude the possibility that a similar trend may appear in other countries. Etiological studies are required to further explain this increase.