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Læknablaðið - 01.12.1976, Side 47

Læknablaðið - 01.12.1976, Side 47
LÆKNABLAÐIÐ 195 the rectum, 59 males and 35 females. Average age was 65.4 years and 64.2 years respectively. Two patients (females) had multiple lesions i. e. cancer both in the colon and rectum. The most common initial symptom in the cancer coli group was abdominal pain but in the cancer recti group the most common initial symptom was change in bowel habits. On the whole, the three most dominating symptoms in the cancer coli group were change in bowel habits in 77%, abdominal pain in 71%, general weakness and loss of weight in 55%. In the cancer recti group the three most common symptoms were change in bowel habits 87%, visible blood in stools 65%, pain in 47%. 54 of the 238 patients with cancer in the large bowel or 23% were admitted to the Surgical Department because of acute illness obstruction or perforation. 136 patients or 57% of the cases came to the Surgical Dspartment within less than 6 months from the onset of symptoms but in 29% the duration of symptoms was from one to three years before admission. 81 patient or 34% consulted a doctor in the first month after onset of symptoms. Of these 41 patient or 50% were admitted for treatment within 1 month from first consultation and 85% within 6 months. 9% of those patients were admitted after a year or more. In a few of these cases it was not possible to discern the reason for the delay in admis- sion. Some were delayed because of normal diagnostic difficulties but in the majority of them, we have to admit that the doctor was to blame. About 53% of these earcinomas should have been detectable with rectal exploration and an ordinary rectosigmoidoscopy i. e. all rectal cancers and 50% of cancer of the sigmoid colon. 226 of the 238 patients or 95% underwent some type of surgical intervention. Palliative or explorative surgery was carried out in 71 cases; with 24% primary mortality in the cancer coli group (50 cases) and 14.3% primary mortality in the cancer recti group (21 cases). Surgery for cure was possible in 88 cases or 62% of the cancer coli group and in 67 cases or 70% of the cancer recti group. Primary mortality was 4.5% in both these groups among the radically treated patients. Five years survival rate of the radically treated (1952-1964) was 51.9%. 5 year sur- vival rate for the whole material with five year observations time (118 cases) was 33.9%.

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