Key result
Surgery for colorectal cancer in centers meeting DKG minimum volume requirements was associated with a 20% lower risk-adjusted hospital mortality (OR 0.80; 95% CI 0.74-0.87; p<0.001).
Why the study?
The study evaluated nationwide hospital mortality and failure to rescue after colorectal cancer surgery based on hospital fulfillment of German Cancer Society minimum volume thresholds.
Does surgery in high-volume centers meeting DKG minimum amounts reduce hospital mortality and failure to rescue in patients with colorectal cancer?
Population
287,227 patients undergoing surgery for colorectal cancer in nationwide hospital billing data
Comparison
Hospitals fully vs partially vs not meeting DKG minimum operative amounts
Design
Retrospective analysis of nationwide hospital billing data
Authors
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May support centralization of colorectal cancer surgery; leaves open causal confirmation in randomized trials.
Observational (n=287,227)
Yes
Does surgery in high-volume centers meeting DKG minimum amounts reduce hospital mortality and failure to rescue in patients with colorectal cancer?
Odds Ratio: 0.8 (95% CI 0.74–0.87)
p-value: p=<0.001
Surgery for colorectal cancer in centers fulfilling minimum volume requirements is associated with significantly lower hospital mortality and failure-to-rescue rates, supporting centralization.
Diers et al. (2020) conducted an observational in Colorectal cancer (n=287,227). Surgery in centers meeting DKG minimum volume amounts vs. Surgery in hospitals partially or not meeting minimum amounts was evaluated on Hospital mortality (OR 0.80, 95% CI 0.74-0.87, p=<0.001). Surgery for colorectal cancer in centers meeting DKG minimum volume requirements was associated with a 20% lower risk-adjusted hospital mortality (OR 0.80; 95% CI 0.74-0.87; p<0.001).
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