ArticleBMC cancer2026
Evolution of treatment patterns and survival outcomes in non-metastatic rectal cancer: a 15-year real-world single-center analysis.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTreatment 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.
methodsWe 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.
resultsThe 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.
conclusionsThese findings demonstrate substantial temporal changes in multidisciplinary rectal cancer management, with improved survival observed over time, supporting the continued refinement of multidisciplinary care strategies.
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