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Surgeon and hospital‐related risk factors in colorectal cancer surgery
Author(s) -
Brännström F.,
Jestin P.,
Matthiessen P.,
Gunnarsson U.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2010.02468.x
Subject(s) - medicine , colorectal cancer , hazard ratio , proportional hazards model , cancer , stage (stratigraphy) , surgery , survival analysis , cohort study , cohort , oncology , general surgery , confidence interval , paleontology , biology
Aim The aim of this study was to identify surgeon and hospital‐related factors in a well‐defined population‐based cohort; the results of this study could possibly be used to improve outcome in colorectal cancer. Method Data from the colonic (1997–2006) and rectal (1995–2006) cancer registers of the Uppsala/Örebro Regional Oncology Centre were used to assess 1697 patients with rectal and 2692 with colonic cancer. Putative risk factors and their impact on long‐term survival were evaluated using the Cox proportional hazard model. Results The degree of specialization of the operating surgeon had no significant effect on long‐term survival. When comparing the surgeons with the highest degree of specialization, noncolorectal surgeons demonstrated a slightly lower long‐term survival for rectal cancer stage I and II (HR, 2.03; 95% CI, 1.05–3.92). Surgeons with a high case‐load were not associated with better survival in any analysis model. Regional hospitals had a lower survival rate for rectal cancer stage III surgery (HR, 1.47; 95% CI, 1.08–2.00). Conclusion Degree of specialization, surgeon case‐load and hospital category could not be identified as important factors when determining outcome in colorectal cancer surgery in this study.