Ryan J McColl1, Colleen E McGahan2, Eric Cai2, Rob Olson3, Winson Y Cheung4, Manoj J Raval1, Paul Terry Phang1, Ahmer A Karimuddin1, Carl J Brown5. 1. Department of Surgery, St. Paul's Hospital, Vancouver, British Columbia, Canada. 2. Surgical Oncology Network, Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. 3. Radiation Therapy Program, British Columbia Cancer Agency, Prince George, British Columbia, Canada. 4. Systemic Therapy Program, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. 5. Section of Colorectal Surgery, Department of Surgery, University of British Columbia, Room C310, St. Paul's Hospital, 1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada. Electronic address: cbrown@providencehealth.bc.ca.
Abstract
BACKGROUND: The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS: This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers performing 20 surgeries or more per year. Primary outcomes were operative and perioperative factors that have proven influence on patient outcomes. RESULTS: In all, 2,081 patients had surgery for rectal cancer. Of these, 1,690 patients had surgery in an HVH and 391 had surgery in a low-volume hospital. On multivariate analysis, patients who had surgery in an HVH were more likely to have sphincter-preserving surgery, 12 or more lymph nodes removed with the tumor, neoadjuvant radiation therapy, and receive pre-operative or postoperative chemotherapy. CONCLUSIONS: For rectal cancer patients in British Columbia, Canada, being treated at an HVH is associated with several quality indicators linked to better patient outcomes.
BACKGROUND: The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS: This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers performing 20 surgeries or more per year. Primary outcomes were operative and perioperative factors that have proven influence on patient outcomes. RESULTS: In all, 2,081 patients had surgery for rectal cancer. Of these, 1,690 patients had surgery in an HVH and 391 had surgery in a low-volume hospital. On multivariate analysis, patients who had surgery in an HVH were more likely to have sphincter-preserving surgery, 12 or more lymph nodes removed with the tumor, neoadjuvant radiation therapy, and receive pre-operative or postoperative chemotherapy. CONCLUSIONS: For rectal cancerpatients in British Columbia, Canada, being treated at an HVH is associated with several quality indicators linked to better patient outcomes.
Authors: Kristen Cagino; Maria S Altieri; Jie Yang; Lizhou Nie; Mark Talamini; Konstantinos Spaniolas; Paula Denoya; Aurora Pryor Journal: Surg Endosc Date: 2017-12-07 Impact factor: 4.584