Nobuaki Hoshino1, Suguru Hasegawa2, Koya Hida2, Kenji Kawada2, Ryosuke Okamura2, Madoka Hamada3, Yoshinori Munemoto4, Yoshiharu Sakai2, Masahiko Watanabe5. 1. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. hoshinob@kuhp.kyoto-u.ac.jp. 2. Department of Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 3. Department of Gastrointestinal Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. 4. Department of Surgery, Fukui-ken Saiseikai Hospital, Fukui, Japan. 5. Department of Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
Abstract
PURPOSE: Hospital factors along with various patient and surgeon factors are considered to affect the prognosis of colorectal cancer. Hospital volume is well known, but little is known regarding other hospital factors. METHODS: We reviewed data on 853 patients with stage IV colorectal cancer who underwent elective palliative primary tumor resection between January 2006 and December 2007. To detect the hospital factors that could influence the prognosis of incurable colorectal cancer, the relationships between patient/hospital factors and overall survival were analyzed. Among hospital factors, hospital type (Group A: university hospital or cancer center; Group B: community hospital), hospital volume, and number of colorectal surgeons were examined. RESULTS: In univariate analysis, Group A hospitals showed significantly better prognosis than Group B hospitals (p = 0.034), while hospital volume and number of colorectal surgeons were not associated with overall survival. After adjustment for patient factors in multivariate analysis, hospital type was significantly associated with overall survival (hazard ratio: 1.31; 95 % confidence interval: 1.05-1.63; p = 0.016). However, there was no significant difference in short-term outcomes between hospital types. CONCLUSIONS: Hospital type was identified as a hospital factor that possibly affects the prognosis of stage IV colorectal cancer patients.
PURPOSE: Hospital factors along with various patient and surgeon factors are considered to affect the prognosis of colorectal cancer. Hospital volume is well known, but little is known regarding other hospital factors. METHODS: We reviewed data on 853 patients with stage IV colorectal cancer who underwent elective palliative primary tumor resection between January 2006 and December 2007. To detect the hospital factors that could influence the prognosis of incurable colorectal cancer, the relationships between patient/hospital factors and overall survival were analyzed. Among hospital factors, hospital type (Group A: university hospital or cancer center; Group B: community hospital), hospital volume, and number of colorectal surgeons were examined. RESULTS: In univariate analysis, Group A hospitals showed significantly better prognosis than Group B hospitals (p = 0.034), while hospital volume and number of colorectal surgeons were not associated with overall survival. After adjustment for patient factors in multivariate analysis, hospital type was significantly associated with overall survival (hazard ratio: 1.31; 95 % confidence interval: 1.05-1.63; p = 0.016). However, there was no significant difference in short-term outcomes between hospital types. CONCLUSIONS: Hospital type was identified as a hospital factor that possibly affects the prognosis of stage IV colorectal cancerpatients.
Authors: Caitlin W Hicks; Elizabeth C Wick; Joseph K Canner; James H Black; Isibor Arhuidese; Umair Qazi; Tammam Obeid; Julie A Freischlag; Mahmoud B Malas Journal: JAMA Surg Date: 2015-07 Impact factor: 14.766
Authors: Michelle van Ryn; Sean M Phelan; Neeraj K Arora; David A Haggstrom; George L Jackson; S Yousuf Zafar; Joan M Griffin; Leah L Zullig; Dawn Provenzale; Mark W Yeazel; Rahul M Jindal; Steven B Clauser Journal: J Clin Oncol Date: 2014-02-03 Impact factor: 44.544