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Background <p>Treatment strategies for rectal adenocarcinoma have undergone substantial evolution, driven by advances in surgical techniques, radiotherapy, and systemic therapies. Nonetheless, longitudinal evidence on their real-world adoption and survival trends remains limited. This study investigated temporal trends in patient characteristics, treatment patterns, and outcomes over a 15-year period at a high-volume Korean tertiary center.</p> Methods <p>We retrospectively evaluated 6,314 patients with non-metastatic rectal adenocarcinoma who received curative-intent treatment between 2008 and 2022. The study period was divided into five consecutive 3-year intervals to facilitate temporal comparisons.</p> Results <p>The mean age at diagnosis was 59.4 years, and 62.0% of patients were male. The proportion of clinical T4 tumors increased substantially, from 7.0% to 28.0%, whereas well-differentiated histology declined over time. Minimally invasive surgery rose from 44.5% to 91.0%, driven by the growing adoption of robotic techniques. Neoadjuvant radiotherapy replaced adjuvant radiotherapy as the predominant approach, and capecitabine-based regimens became the most frequent systemic therapy. Across the entire cohort, the 5-year survival rate was 87.6%, with overall survival showing steady improvement across study periods. Relative to the general population, the standardized mortality ratio declined from 5.57 in Period 1 to 3.33 in Period 5, reflecting a measurable reduction in excess mortality. Among patients with locally advanced disease, the highest five-year survival rate was 88.4% in those treated with neoadjuvant therapy followed by surgery.</p> Conclusions <p>These findings demonstrate substantial temporal changes in multidisciplinary rectal cancer management, with improved survival observed over time, supporting the continued refinement of multidisciplinary care strategies.</p>

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Evolution of treatment patterns and survival outcomes in non-metastatic rectal cancer: a 15-year real-world single-center analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月16日

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  • Jeong Yun Jang,
  • Haesol Lim,
  • Jiyeon Ko,
  • Jeong Ha Lee,
  • Yuwon Kim,
  • Sang Ah Chi,
  • Gyu Sang Yoo,
  • Hee Chul Park,
  • Nalee Kim,
  • Yong Beom Cho,
  • Jeong Il Yu

摘要

Background

Treatment strategies for rectal adenocarcinoma have undergone substantial evolution, driven by advances in surgical techniques, radiotherapy, and systemic therapies. Nonetheless, longitudinal evidence on their real-world adoption and survival trends remains limited. This study investigated temporal trends in patient characteristics, treatment patterns, and outcomes over a 15-year period at a high-volume Korean tertiary center.

Methods

We retrospectively evaluated 6,314 patients with non-metastatic rectal adenocarcinoma who received curative-intent treatment between 2008 and 2022. The study period was divided into five consecutive 3-year intervals to facilitate temporal comparisons.

Results

The mean age at diagnosis was 59.4 years, and 62.0% of patients were male. The proportion of clinical T4 tumors increased substantially, from 7.0% to 28.0%, whereas well-differentiated histology declined over time. Minimally invasive surgery rose from 44.5% to 91.0%, driven by the growing adoption of robotic techniques. Neoadjuvant radiotherapy replaced adjuvant radiotherapy as the predominant approach, and capecitabine-based regimens became the most frequent systemic therapy. Across the entire cohort, the 5-year survival rate was 87.6%, with overall survival showing steady improvement across study periods. Relative to the general population, the standardized mortality ratio declined from 5.57 in Period 1 to 3.33 in Period 5, reflecting a measurable reduction in excess mortality. Among patients with locally advanced disease, the highest five-year survival rate was 88.4% in those treated with neoadjuvant therapy followed by surgery.

Conclusions

These findings demonstrate substantial temporal changes in multidisciplinary rectal cancer management, with improved survival observed over time, supporting the continued refinement of multidisciplinary care strategies.