Full-text resources of PSJD and other databases are now available in the new Library of Science.
Visit https://bibliotekanauki.pl

PL EN


Preferences help
enabled [disable] Abstract
Number of results
2007 | 79 | 6 | 403-409

Article title

Is the Surgeon's Experience an Independent Prognostic Factor in Rectal Cancer?

Content

Title variants

Languages of publication

EN

Abstracts

EN
The aim of the study was to evaluate the influence of the surgeons' caseload on the results of therapy in rectal cancer.Material and methods. 286 consecutive patients (155 males and 131 females) were enrolled and operated on for rectal cancer stage T2 (112 patients) and T3 (174 patients) in 8 surgical centers of Szczecin between January 1993 and December 1997. Studied group included about 79% of radically operated patients due were to rectal cancer in analyzed period.Results. The patients were assigned to one of two groups with regard to the surgeon's caseload. The first group was comprised of 116 patients (including 72 stage T3 and 54 stage T2 patients) operated on by surgeons more experienced in rectal surgery and the second group was comprised of 160 patients operated on by 36 surgeons with fewer caseloads. The surgeon's experience in rectal surgery was measured by the surgeon's caseload throughout the entire study period. We considered surgeons with greater than 25 cases over the study period experienced.Analysis of survival with regard to the managing center revealed significant differences for stage T3, with 5-year-survival rates ranging from 14% to 60%. Distinct differences were also noted for survival rates in stage T2 (5-year-survival rates ranged from 38% to 86%); however, these differences were not statistically significant. Analysis of the influence of surgeon's caseload on outcomes in rectal cancer revealed a significant influence in stage T3 and a lack of influence in stage T2.Conclusion. The surgeon's experience is an independent prognostic factor for stage T3 rectal cancer patients.

Year

Volume

79

Issue

6

Pages

403-409

Physical description

Dates

published
1 - 6 - 2007
online
27 - 11 - 2007

Contributors

  • Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin
  • Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin
  • Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin
  • Department of General and Oncological Surgery, Pomeranian Medical University in Szczecin
  • Chair and Department of Histology and Embriology, Pomeranin Medical University in Szczecin

References

  • Didowska J, Wojciechowska U, Tarkowski W i wsp.: Nowotwory złośliwe w Polsce w 1999 roku. Centrum Onkologii, Warszawa 2002.
  • Gatta G, Faivre J, Capocaccia R et al.: Eurocare Working Group. Survival of colorectal cancer patients in Europe during the period 1978-1989. Eur J Cancer 1998; 14: 2176-83.
  • Porter GA, Soskolne CL, Yakimetes WW et al.: Surgeon-related factors and outcome in rectal cancer. Ann Surg 1998; 227: 157-67.
  • Hermanek P, Hermanek PJ: Role of the surgeon as a variable in the treatment of rectal cancer. Semin Surg Oncol 2000; 19(4): 329-35.[PubMed][Crossref]
  • Kee F, Wilson RH, Harper C et al.: Influence of hospital and clinician workload in survival from colorectal cancer: cohort study. BMJ 1999; 318: 1381-86.
  • Parry JM, Collins S, Mathers J et al.: Influence of volume of work on the outcome of treatment for patients with colorectal cancer. Br J Surg 1999; 86(4): 475-81.
  • Beck DE: Colorectal operative experience. Results of a survey. Dis Colon Rectum 1994; 37(9): 905-08.[Crossref][PubMed]
  • Garcia-Granero E, Marti-Obiol R, Gomez-Barbadillo J et al.: Impact of surgeon organization and specialization in rectal cancer outcome. Colorectal Dis 2001; 3: 179-84.[Crossref]
  • Holm T, Johansson H, Cedermark B et al.: Influence of hospital and surgeon-related factors on outcome after treatment of rectal cancer with or without preoperative radiotherapy. Br J Surg 1997; 84(5): 657-63.
  • Machado M, Goldman S, Jarhult J: Improved survival in rectal cancer surgery - an effect of specialization? Colorectal Dis 2000; 2: 264-69.[Crossref][PubMed][WoS]
  • McArdle CS, Hole D: Impact of variability among surgeons on postoperative morbidity and mortality and ultimate survival. BMJ 1991; 302: 1501-05.
  • Nowacki MP: Nowotwory jelita grubego. Standardy leczenia systemowego nowotworów złośliwych u dorosłych w Polsce. Red: Krokowski M. PTOK, Warszawa 1999.
  • Oldhoff J: Conservative surgery: achievements, risks and limitations. Eur J Surg Oncol 1992; 18(3): 205-08.[PubMed]
  • Reinbach DH, McGregor JR, Murray GD et al.: Effect of the surgeon's specialty interest on the type of resection performed for colorectal cancer. Dis Colon Rectum 1994; 37(10): 1020-23.[Crossref]
  • Finlayson EV, Goodney PP, Birkmeyer JD: Hospital volume and operative mortality in cancer surgery: a national study. Arch Surg 2003; 138(7): 721-26.[PubMed][Crossref]
  • Pawlęga J, Łabza H, Popiela T: Badania populacyjne nad przeżyciami, diagnostyką i leczeniem raka jelita grubego w dwóch okresach czasu. Pol Przegl Chir 1996; 38(8): 784-93.
  • Pawlęga J, Eurocare Working Group: Rak jelita grubego w Polsce oraz innych krajach Europy - diagnostyka, metody leczenia i przeżycie. Pol Przegl Chir 1994; 66: 886-93.
  • Myerson RJ, Singh A, Birnbaum EH et al.: Pretreatment clinical findings predict outcome for patients receiving preoperative radiation for rectal cancer. Int J Radiat Oncol Biol Phys 2001; 50 (3): 665-74.[PubMed][Crossref]
  • Nowacki MP: Nowotwory Jelita Grubego. Red. Nowacki MP. Wiedza i Życie. Warszawa 1996: 11-12.
  • Read TE, Myerson RJ, Fleshman JW et al.: Surgeon specialty is associated with outcome in rectal cancer treatment. Dis Colon Rectum 2002; 45(7): 904-14.[Crossref]
  • Martling A, Cedermark B, Johansson H et al.: The surgeon as a prognostic factor after the introduction of total mesorectal excision in the treatment of rectal cancer. Br J Surg 2002; 89(8): 1008-13.
  • Martling AL, Holm T, Rutqvist LE et al.: Effect of a surgical training programme on outcome of rectal cancer in the county of Stockholm. Stockholm Colorectal Cancer Study Group, Basingstoke Bowel Cancer Research Project. Lancet 2000; 356: 93-96.
  • Hermanek P, Wiebelt H, Staimmer D et al.: Prognostic factors of rectum carcinoma - experience of the German Multicentre Study SGCRC. German Study Group Colo-Rectal Carcinoma. Tumori 1995; 81(3 Suppl): 60-64.
  • Stocchi L, Nelson H, Sargent DJ et al.: Impact of surgical and pathologic variables in rectal cancer: a United States community and cooperative group report. J Clin Oncol 2001; 19 (18): 3895-902.
  • Kraemer M, Wiratkapun S, Seow-Choen F et al.: Stratifying risk factors for follow-up: a comparison of recurrent and nonrecurrent colorectal cancer. Dis Colon Rectum 2001; 44(6): 815-21.[PubMed][WoS][Crossref]
  • Secco GB, Ravera G, Bonfante P et al.: Prognostic indicators of local recurrence in patients operated for rectal cancer. Hepatogastroenterology 2001; 48 (41): 1346-50.
  • Tytherleigh M, Wheeler J, Birks M et al.: Surgical specialist registrars can safely perform resections for carcinoma of the rectum. Ann R Coll Surg Engl 2002; 84 (6): 389-92.
  • McArdle CS, Hole DJ: Outcome following surgery for colorectal cancer: analysis by hospital after adjustment for case-mix and deprivation. Br J Cancer 2002; 86(3): 331-35.[PubMed][Crossref]
  • Platell C, Lim D, Tajudeen N et al.: Dose surgical sub-specialization influence survival in patients with colorectal cancer? World J Gastroenterol 2003; 9 (5): 961-64.
  • Meyerhardt JA, Tepper JE, Niedzwiecki D et al.: Impact of body mass index on outcomes and treatment-related toxicity in patients with stage II and III rectal cancer: findings from Intergroup Trial 0114. J Clin Oncol 2004; 22(1): 166-74.
  • Mc Ardle CS, Hole D: Influence of volume and specialization on survival following surgery for colorectal cancer. BJS 2004; 91:610-17.[Crossref]
  • Hermanek P, Weibelt H, Staimmer D et al.: Prognostic factors of rectum carcinoma - experience of the German SGCRC Multicentre Study SGRC, German Study Group Colo-rectal Carcinoma Tumori, 1995; 81 (Suppl.) 60-64.
  • Holm T, Johansson H, Cedermark B et al.: Influence of hospital and surgeon - related factors on outcome after treatment of rectal cancer with or without preoperative radiotherapy. BJS 1997; 84: 657-63.[Crossref]
  • Smith JAL, King PM, Lane RHS et al.: Evidence of the effect of specialization on the management, surgical outcome and survival from colorectal cancer in Wessex. BJS 2003; 90: 583-92.[Crossref]
  • Porter GA., Soskolne CL, Yakimets WW et al.: Surgeon - related factors and out come In rectal cancer. Ann Surg 1998; 227: 157-67.
  • Callahan MA, Christos PJ, Heather TG et al.: Influence of surgical subspecialty training on in - hospital mortality for gastrectomy and colectomy patients. Ann Surg 2003; 238(4): 629-36.
  • Brennan MF: Safety in numbers. Br J Surg 2004; 91: 653-54.

Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_v10035-007-0063-1
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.