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Surgeon and hospital-related risk factors in colorectal cancer surgery
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
2011 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 13, no 12, 1370-1376 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to identify surgeon and hospital-related factors in a well-defined populationbased 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/Orebro 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.

Place, publisher, year, edition, pages
2011. Vol. 13, no 12, 1370-1376 p.
Keyword [en]
Colon cancer, rectal cancer, formal competence, case load, hospital category, long-term survival, population based
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-162680DOI: 10.1111/j.1463-1318.2010.02468.xISI: 000296960300014OAI: oai:DiVA.org:uu-162680DiVA: diva2:462559
Available from: 2011-12-07 Created: 2011-12-05 Last updated: 2012-05-14Bibliographically approved

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Brännström, FredrikJestin, Pia
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