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The Impact of Hospital Volume on Surgical Outcome in Patients with Rectal Cancer

Kressner, Marit; Bohe, Måns LU ; Cedermark, Bjorn; Dahlberg, Michael; Damber, Lena; Lindmark, Gudrun LU ; Ojerskog, Bjorn; Sjodahl, Rune; Johansson, Robert and Pahlman, Lars (2009) Swedish Surgical Week, 2008 In Diseases of the Colon & Rectum 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)
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author
organization
publishing date
type
Chapter in Book/Report/Conference proceeding
publication status
published
subject
keywords
Local recurrence, Survival, Outcome, Caseload, Rectal cancer, Hospital volume
in
Diseases of the Colon & Rectum
volume
52
issue
9
pages
1542 - 1549
publisher
Lippincott Williams & Wilkins
conference name
Swedish Surgical Week, 2008
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
2010-02-25 14:11:56
date last changed
2017-12-10 03:40:29
@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 (&lt; 11, 11-25, or &gt;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},
  keyword      = {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},
  volume       = {52},
  year         = {2009},
}