Key result
High-volume surgeons linked to ~42% lower perioperative mortality in elective colorectal cancer surgery.
Why the study?
The impact of surgeon volume and specialization on short-term outcomes in colorectal cancer surgery was not fully determined.
Does surgery by high-volume or specialist surgeons improve short-term outcomes in patients with colorectal cancer?
Population
8219 patients with colorectal cancer treated between 1998 and 2002
Comparison
High-volume surgeons and colorectal specialists vs low-volume surgeons and non-specialists
Design
Population-based observational audit with multivariate logistic regression analysis
Follow-up
Perioperative
Authors
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High-volume surgeons were associated with lower elective mortality and more restorative rectal procedures; supports centralization policies but leaves causality open to prospective trials.
Observational (n=8,219)
Yes
Does surgery by high-volume or specialist surgeons improve short-term outcomes in patients with colorectal cancer?
Odds Ratio: 0.58 (95% CI 0.44–0.76)
p-value: p=<0.001
High-volume surgeons and colorectal specialists achieve better short-term outcomes, including lower perioperative mortality and higher rates of sphincter-saving surgery, in elective colorectal cancer resections.
Borowski et al. (2007) conducted an observational in colorectal cancer (n=8,219). High surgeon volume (≥18.5 annual caseload) and specialization vs. Low surgeon volume and non-specialization was evaluated on Perioperative mortality in elective surgery (OR 0.58, 95% CI 0.44-0.76, p=<0.001). High-volume surgeons (≥18.5 annual cases) were associated with a lower risk of perioperative death in elective colorectal cancer surgery (OR 0.58; 95% CI 0.44-0.76; P<0.001).
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