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There is strong evidence that colorectal cancer survival differs between socioeconomic groups. We analysed data on 2481 patients diagnosed during 1989-1997 and recruited to a randomised controlled clinical trial (AXIS, ISRCTN32414363) of chemotherapy and radiotherapy for colorectal cancer. Crude and relative survival at 1 and 5 years was estimated in five categories of socioeconomic deprivation. Multiple imputation was used to account for missing data on tumour stage. A multivariable fractional polynomial model was fitted to estimate the excess hazard of death in each deprivation category, adjusting for the confounding effects of age, stage, cancer site (colon, rectum) and sex, using generalised linear models. Relative survival in the trial patients was higher than in the general population of England and Wales. The socioeconomic gradient in survival was much smaller than that seen for colorectal cancer patients in the general population, both at 1 year -3.2% (95% CI -7.3 to 1.0%, P=0.14) and at 5 years -1.7% (95% CI -8.3 to 4.9%, P=0.61). Given equal treatment, colorectal cancer survival in England and Wales does not appear to depend on socioeconomic status, suggesting that the socioeconomic gradient in survival in the general population could well be due to health-care system factors. [ABSTRACT FROM AUTHOR]

The article focuses on a study which examined whether a pathological complete response in the primary tumor following pre-operative chemoradiation (CRT) for T3-T4 rectal cancer can predict a response within the perirectal lymph nodes, a low risk of local recurrence and the appropriateness of local excision. The characteristics, treatment details and outcome of patients undergoing preoperative CRT for rectal carcinomas considered unresectable between November 1993 and August 2003 were recorded. Patients were reassessed after completing CRT. Planned surgical resection was carried out after treatment. 68 patients did not proceed to surgery due to preoperative death, inoperable disease and patient refusal or concurrent medical problems.

Abstract Chemoradiotherapy is the standard treatment for most patients with epidermoid anal cancer. Pre-treatment staging is based on size for T1-T3 lesions and clinical and radiological assessment of adjacent organ invasion for T4 lesions. For patients with residual or recurrent carcinoma, anorectal excision offers the best chance of oncological salvage. Pathological staging systems for anorectal excision specimens were validated at the time when surgical treatment was first line therapy. A validated staging system is necessary for salvage surgical excision specimens following an attempt to cure by radiotherapy and chemotherapy for the purpose of prognosis and further treatment planning. [ABSTRACT FROM AUTHOR]

The article focuses on the treatment of anal cancer. Earlier, the disease was treated mainly by surgeons, and patients had to undergo rectal excision. However, in 1974, surgeon Norman Nigro proposed that anal cancer could be treated by radiotherapy and chemotherapy, and patients needed to be referred to an oncologist, instead of a surgeon. Radiotherapy and chemotherapy were found to be very successful for the treatment of the disease.