Colorectal cancer: is the surgeon a prognostic factor?: A systematic review

OBJECTIVE: To assess whether there is evidence that the surgeon is a prognostic factor in the treatment of colorectal cancer. DATA SOURCE: MEDLINE 1985-February 1999, and bibliographies of retrieved articles. STUDY SELECTION: Publications which analysed the outcome of patients with colorectal cancer and in which one of the variables analysed was the surgeon. RESULTS: Thirteen studies were identified which addressed the outcome measures: post-operative mortality, anastomotic leak rate, local recurrence rate, and long-term survival. For these outcomes, different surgeons achieve significantly different results, with experienced and specialist surgeons achieving significantly better results than other surgeons. CONCLUSION: The current data strongly suggest that the surgeon is an important prognostic factor in the treatment of colorectal cancer.