Assessment of management practices for colonic cancer in the Paris metropolitan area in 2002.

Objective: To assess the management of patients aged 18 years or older with colonic adenocarcinoma (including the rectosigmoid junction), compared with French guidelines (ANAES and SOR).

Methods: This retrospective study carried out in 2003 by the Ile-de-France regional union of health insurance funds from hospital discharge and operative and pathology reports of patients exempted from copayment between April 2001 and March 2002.

Results: In all, 1 842 patients were included; mean age was 68.7 +/- 12.7 years and the M/F ratio was 1.09. 17.3% of patients were diagnosed after complications (obstruction, perforation); 25.1% had synchronous metastases, 79.7% with at least one liver metastasis. Serum CEA assay was performed in 50.0% of patients, in combination with CA 19-9 in 31.1% of patients. In 24.9%, less than 8 lymph nodes were analyzed. 37.7% of stage II patients had chemotherapy while 10.8% of stage III and 9.8% of stage IV patients did not. Age was a determining factor in the decision of chemotherapy (P<0.0001).

Conclusion: Implementation of guidelines for the management of colon cancer can be improved, notably regarding pathologic analysis and indications of chemotherapy.