Key result
Individual surgeon choice linked to up to ~4-fold variation in colorectal cancer survival.
Why the study?
Significant variations in postoperative complications, mortality, and survival among surgeons performing colorectal cancer surgery were not well characterized.
Does the individual surgeon performing the procedure impact postoperative morbidity, mortality, and survival in patients with colorectal cancer?
Population
645 sequential patients with colorectal cancer at Royal Infirmary, Glasgow from 1974 to 1979
Comparison
Outcomes among 13 consultant surgeons without special interest in colorectal surgery
Design
Prospective cohort study
Follow-up
Up to 10 years
Authors
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Surgeon variation compromises colorectal cancer survival; leaves open whether specialization narrows disparities today.
Cohort (n=645)
No
Does the individual surgeon performing the procedure impact postoperative morbidity, mortality, and survival in patients with colorectal cancer?
Effect estimate: HR 0.56 to 2.03
Significant variations in patient outcomes exist among general surgeons performing colorectal cancer surgery, suggesting a need for subspecialty training or surgical oncology expertise.
McArdle et al. (1991) conducted a cohort in Colorectal cancer (n=645). Individual surgeon (variability among 13 surgeons) vs. Other surgeons combined was evaluated on Survival after curative resection (HR 0.56 to 2.03). Among patients undergoing surgery for colorectal cancer, adjusted hazard rate ratios for survival varied significantly among 13 surgeons, ranging from 0.56 to 2.03 for curative resection.
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