Does the Choice of Hospital Increase a Chance of Survival in Rectal Cancer?

• Authors: Mariusz Pawlak , Zbigniew Morawiec , Łukasz Dziki , Jan Morawiec , Agnieszka Kolacińska , Adam Dziki
• Languages of publication: EN

Abstracts

EN

was to assess the impact of hospital caseload on long-term outcomes of rectal cancer patients. We posed two questions: 1. Does the number of operations carried out in the surgical department influence five year survival and local recurrence rates? 2. Does surgery alone without adjuvant therapy performed in the particular department affect long-term results?Material and methods. 215 consecutive rectal cancer patients treated in six hospitals of the Łódź district between 1994 and 1998 were enrolled into this prospective study. We analyzed patients in whom local excision, low anterior resection, abdominoperineal resection and Hartmann’s procedure were performed. 27 percent of patients received adjuvant therapy such as radio- or chemotherapy or both. Long-term results were compared between high and low volume institutions by means of local recurrence and five year survival rates.Results. In high volume departments; 69.2% of five year survival rates were obtained versus 46.6% for low volume institutions (p=0.00433). Similar differences were noted comparing local recurrence rates between the aforementioned groups: 19.7% versus 36.5%, respectively (p=0.00430). In surgically treated patients who did not receive adjuvant therapy statistically significant differences were found: 76.5% of patients operated on in high volume hospitals survived five years as compared with 42.9% for low caseload institutions (p=0.00013). Local recurrence rates were 15.5% for high caseload institutions and 38.5% for low caseload hospitals (p=0.00042).Conclusions. High volume hospitals achieved better results in rectal cancer patients with regard to five year survival and local recurrence rates. Better outcomes were also obtained in high caseload departments regarding surgically treated patients who did not receive adjuvant therapy.

Keywords

EN

rectal cancer; prognostic factors; hospital caseload; 5-year survival; local recurrence

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2012
• Volume: 84
• Issue: 12
• Pages: 638-645

Dates

published

1 - 12 - 2012

online

09 - 02 - 2013

Contributors

author

Mariusz Pawlak

• Department of Surgical Oncology, Copernicus Memorial Hospital in Łódź

author

Zbigniew Morawiec

• Department of Surgical Oncology, Copernicus Memorial Hospital in Łódź

author

Łukasz Dziki

• Department of General and Colorectal Surgery, Medical University in Łódź

author

Jan Morawiec

• Department of General and Colorectal Surgery, Medical University in Łódź

author

Agnieszka Kolacińska

• Department of Surgical Oncology, Copernicus Memorial Hospital in Łódź

author

Adam Dziki

• Department of General and Colorectal Surgery, Medical University in Łódź

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Identifiers

DOI

10.2478/v10035-012-0105-1