Centralization of rectal cancer surgery improves long-term survival
2010 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 12, no 9, 874-879 p.Article in journal (Refereed) Published
Aim In 1996, rectal cancer surgery in the Swedish county of Vastmanland was centralized to a single colorectal unit. At the same time, total mesorectal excision and multidisciplinary team meetings were introduced. The aim of this audit was to determine the long-term results before and after centralization. Method All consecutive rectal cancer patients who underwent curative or palliative surgery at one of the county's four hospitals between 1993 and 1996 (n = 133, group 1) were compared with patients operated at the new centralized colorectal unit between 1996 and 1999 (n = 144, group 2). Results Preoperative radiotherapy was common in both groups, but in group 2, it was planned using MRI. Local recurrences were detected in 8% of all patients operated in group 1 vs 3.5% in group 2 (P = 0.043). The overall 5-year survival for all patients in group 1 was 38 vs 62% in group 2 (P = 0.003). According to multivariate analysis, the new colorectal unit was an independent predictor for improved long-term survival. Conclusion This population-based audit shows reduced local recurrence rate and prolonged overall survival for rectal cancer patients after centralization to a single colorectal unit with multidisciplinary management and increased subspecialization.
Place, publisher, year, edition, pages
2010. Vol. 12, no 9, 874-879 p.
Rectal cancer, surgery, centralization, survival
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-135406DOI: 10.1111/j.1463-1318.2009.02098.xISI: 000280990100007OAI: oai:DiVA.org:uu-135406DiVA: diva2:374986