Influence of Individual Surgeon Volume on Oncological Outcome of Colorectal Cancer Surgery.

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2015-01-01 Epub Date: 2015-09-03 DOI:10.1155/2015/464570
Marleen Buurma, Hidde M Kroon, Marlies S Reimers, Peter A Neijenhuis
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引用次数: 26

Abstract

Background: Surgery performed by a high-volume surgeon improves short-term outcomes. However, not much is known about long-term effects. Therefore we performed the current study to evaluate the impact of high-volume colorectal surgeons on survival.

Methods: We conducted a retrospective analysis of our prospectively collected colorectal cancer database between 2004 and 2011. Patients were divided into two groups: operated on by a high-volume surgeon (>25 cases/year) or by a low-volume surgeon (<25 cases/year). Perioperative data were collected as well as follow-up, recurrence rates, and survival data.

Results: 774 patients underwent resection for colorectal malignancies. Thirteen low-volume surgeons operated on 453 patients and 4 high-volume surgeons operated on 321 patients. Groups showed an equal distribution for preoperative characteristics, except a higher ASA-classification in the low-volume group. A high-volume surgeon proved to be an independent prognostic factor for disease-free survival in the multivariate analysis (P = 0.04). Although overall survival did show a significant difference in the univariate analysis (P < 0.001) it failed to reach statistical significance in the multivariate analysis (P = 0.09).

Conclusions: In our study, a higher number of colorectal cases performed per surgeon were associated with longer disease-free survival. Implementing high-volume surgery results in improved long-term outcome following colorectal cancer.

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个体外科医生数量对结直肠癌手术预后的影响。
背景:由大容量外科医生进行的手术可改善短期预后。然而,对长期影响的了解并不多。因此,我们进行了当前的研究,以评估大容量结肠直肠手术对生存率的影响。方法:我们对2004年至2011年间前瞻性收集的结直肠癌数据库进行回顾性分析。患者分为两组:大容量外科医生(>25例/年)和小容量外科医生(结果:774例患者行结直肠恶性肿瘤切除术)。13名小容量外科医生手术453例,4名大容量外科医生手术321例。各组术前特征分布均匀,除低容积组asa分级较高外。在多变量分析中,高容量外科医生被证明是无病生存的独立预后因素(P = 0.04)。虽然在单因素分析中总生存率有显著差异(P < 0.001),但在多因素分析中未达到统计学意义(P = 0.09)。结论:在我们的研究中,每位外科医生手术的结直肠病例数量越多,无病生存期越长。实施大容量手术可改善结直肠癌后的长期预后。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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