M Hosseinali Khani1, K Smedh. 1. Colorectal Unit, Department of Surgery and Centre for Clinical Research of Uppsala University, Central Hospital, Västerås, Sweden. maziar.hosseinalikhani@ltv.se
Abstract
AIM: In 1996, rectal cancer surgery in the Swedish county of Vstmanland was centralized to a single colorectal unit. At the same time, total mesorectal excision and multidisciplinary team meetings were introduced. The aim of this audit was to determine the long-term results before and after centralization. METHOD: All consecutive rectal cancer patients who underwent curative or palliative surgery at one of the county's four hospitals between 1993 and 1996 (n = 133, group 1) were compared with patients operated at the new centralized colorectal unit between 1996 and 1999 (n = 144, group 2). RESULTS: Preoperative radiotherapy was common in both groups, but in group 2, it was planned using MRI. Local recurrences were detected in 8% of all patients operated in group 1 vs 3.5% in group 2 (P = 0.043). The overall 5-year survival for all patients in group 1 was 38 vs 62% in group 2 (P = 0.003). According to multivariate analysis, the new colorectal unit was an independent predictor for improved long-term survival. CONCLUSION: This population-based audit shows reduced local recurrence rate and prolonged overall survival for rectal cancer patients after centralization to a single colorectal unit with multidisciplinary management and increased subspecialization.
AIM: In 1996, rectal cancer surgery in the Swedish county of Vstmanland was centralized to a single colorectal unit. At the same time, total mesorectal excision and multidisciplinary team meetings were introduced. The aim of this audit was to determine the long-term results before and after centralization. METHOD: All consecutive rectal cancerpatients who underwent curative or palliative surgery at one of the county's four hospitals between 1993 and 1996 (n = 133, group 1) were compared with patients operated at the new centralized colorectal unit between 1996 and 1999 (n = 144, group 2). RESULTS: Preoperative radiotherapy was common in both groups, but in group 2, it was planned using MRI. Local recurrences were detected in 8% of all patients operated in group 1 vs 3.5% in group 2 (P = 0.043). The overall 5-year survival for all patients in group 1 was 38 vs 62% in group 2 (P = 0.003). According to multivariate analysis, the new colorectal unit was an independent predictor for improved long-term survival. CONCLUSION: This population-based audit shows reduced local recurrence rate and prolonged overall survival for rectal cancerpatients after centralization to a single colorectal unit with multidisciplinary management and increased subspecialization.
Authors: Noura Alhassan; Mei Yang; Nathalie Wong-Chong; A Sender Liberman; Patrick Charlebois; Barry Stein; Gerald M Fried; Lawrence Lee Journal: Surg Endosc Date: 2018-09-12 Impact factor: 4.584
Authors: Aaron S Rickles; David W Dietz; George J Chang; Steven D Wexner; Mariana E Berho; Feza H Remzi; Frederick L Greene; James W Fleshman; Maher A Abbas; Walter Peters; Katia Noyes; John R T Monson; Fergal J Fleming Journal: Ann Surg Date: 2015-12 Impact factor: 12.969
Authors: Kyle Freischlag; Zhifei Sun; Mohamed A Adam; Jina Kim; Manisha Palta; Brian G Czito; John Migaly; Christopher R Mantyh Journal: JAMA Surg Date: 2017-06-01 Impact factor: 14.766
Authors: Antonella Colasante; Antonietta Augurio; Raffaella Basilico; Antonio Raffaele Cotroneo; Maria B Di Sciascio; Giuseppe Gaspari; Domenico Genovesi; Jamara Giampietro; Romina Iantorno; Antonio Marchetti; Clara Natoli; Antonello Nuzzo; Floriana Ottaviani; Paolo Pompa; Pietro Castellan; Raffaele Tenaglia; Annamaria Vinciguerra Journal: Oncol Lett Date: 2017-11-30 Impact factor: 2.967