The Impact of Hospital Volume on Surgical Outcome in Patients with Rectal Cancer
(2009) Swedish Surgical Week, 2008 52(9). p.1542-1549- Abstract
- PURPOSE: This study was designed to investigate, in a population-based setting, the surgical outcome in patients with rectal cancer according to the hospital volume. METHODS: Since 1995 all patients with rectal cancer have been registered in the Swedish Rectal Cancer Registry. Hospitals were classified, according to number treated per year, as low-volume, intermediate-volume, or high-volume hospitals (< 11, 11-25, or >25 procedures per year). Postoperative mortality, reoperation rate within 30 days, local recurrence rate, and overall five-year survival were studied. For postoperative morbidity and mortality the whole cohort from 1995 to 2003 (n = 10,425) was used. For cancer-related outcome only, those with five-year follow-ups, from... (More)
- PURPOSE: This study was designed to investigate, in a population-based setting, the surgical outcome in patients with rectal cancer according to the hospital volume. METHODS: Since 1995 all patients with rectal cancer have been registered in the Swedish Rectal Cancer Registry. Hospitals were classified, according to number treated per year, as low-volume, intermediate-volume, or high-volume hospitals (< 11, 11-25, or >25 procedures per year). Postoperative mortality, reoperation rate within 30 days, local recurrence rate, and overall five-year survival were studied. For postoperative morbidity and mortality the whole cohort from 1995 to 2003 (n = 10,425) was used. For cancer-related outcome only, those with five-year follow-ups, from 1995 to 1998, were used (n = 4,355). RESULTS: In this registry setting the postoperative mortality rate was 3.6% in low-volume hospitals, and 2.2% in intermediate- volume and high-volume hospitals (P = 0.002). The reoperation rate was 10%, with no differences according to volume. The overall local recurrence rates were 9.4%, 9.3%, and 7.5%, respectively (P = 0.06). Significant difference was found among the nonirradiated patients (P = 0.004), but not among the irradiated patients (P = 0.45). No differences were found according to volume in the absolute five-year survival. CONCLUSION: Postoperative mortality and local recurrence in nonirradiated patients were lower in high-volume hospitals. No difference was seen between volumes in reoperation rates, overall local recurrence, or absolute five-year survival. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1546658
- author
- Kressner, Marit ; Bohe, Måns LU ; Cedermark, Bjorn ; Dahlberg, Michael ; Damber, Lena ; Lindmark, Gudrun LU ; Ojerskog, Bjorn ; Sjodahl, Rune ; Johansson, Robert and Pahlman, Lars
- organization
- publishing date
- 2009
- type
- Chapter in Book/Report/Conference proceeding
- publication status
- published
- subject
- keywords
- Local recurrence, Survival, Outcome, Caseload, Rectal cancer, Hospital volume
- host publication
- Diseases of the Colon & Rectum
- volume
- 52
- issue
- 9
- pages
- 1542 - 1549
- publisher
- Lippincott Williams & Wilkins
- conference name
- Swedish Surgical Week, 2008
- conference location
- Umea, Sweden
- conference dates
- 2008-08-18 - 2008-08-22
- external identifiers
-
- wos:000273644900002
- scopus:70249136163
- ISSN
- 0012-3706
- 1530-0358
- DOI
- 10.1007/DCR.0b013e3181af58f4
- language
- English
- LU publication?
- yes
- id
- 9a573e12-2406-474a-9872-dd8a1c41fc3b (old id 1546658)
- date added to LUP
- 2016-04-01 11:41:41
- date last changed
- 2024-10-08 06:20:45
@inproceedings{9a573e12-2406-474a-9872-dd8a1c41fc3b, abstract = {{PURPOSE: This study was designed to investigate, in a population-based setting, the surgical outcome in patients with rectal cancer according to the hospital volume. METHODS: Since 1995 all patients with rectal cancer have been registered in the Swedish Rectal Cancer Registry. Hospitals were classified, according to number treated per year, as low-volume, intermediate-volume, or high-volume hospitals (< 11, 11-25, or >25 procedures per year). Postoperative mortality, reoperation rate within 30 days, local recurrence rate, and overall five-year survival were studied. For postoperative morbidity and mortality the whole cohort from 1995 to 2003 (n = 10,425) was used. For cancer-related outcome only, those with five-year follow-ups, from 1995 to 1998, were used (n = 4,355). RESULTS: In this registry setting the postoperative mortality rate was 3.6% in low-volume hospitals, and 2.2% in intermediate- volume and high-volume hospitals (P = 0.002). The reoperation rate was 10%, with no differences according to volume. The overall local recurrence rates were 9.4%, 9.3%, and 7.5%, respectively (P = 0.06). Significant difference was found among the nonirradiated patients (P = 0.004), but not among the irradiated patients (P = 0.45). No differences were found according to volume in the absolute five-year survival. CONCLUSION: Postoperative mortality and local recurrence in nonirradiated patients were lower in high-volume hospitals. No difference was seen between volumes in reoperation rates, overall local recurrence, or absolute five-year survival.}}, author = {{Kressner, Marit and Bohe, Måns and Cedermark, Bjorn and Dahlberg, Michael and Damber, Lena and Lindmark, Gudrun and Ojerskog, Bjorn and Sjodahl, Rune and Johansson, Robert and Pahlman, Lars}}, booktitle = {{Diseases of the Colon & Rectum}}, issn = {{0012-3706}}, keywords = {{Local recurrence; Survival; Outcome; Caseload; Rectal cancer; Hospital volume}}, language = {{eng}}, number = {{9}}, pages = {{1542--1549}}, publisher = {{Lippincott Williams & Wilkins}}, title = {{The Impact of Hospital Volume on Surgical Outcome in Patients with Rectal Cancer}}, url = {{http://dx.doi.org/10.1007/DCR.0b013e3181af58f4}}, doi = {{10.1007/DCR.0b013e3181af58f4}}, volume = {{52}}, year = {{2009}}, }