Patients with colorectal cancer who undergo surgery at higher-volume providers may face better outcomes, according to a Taiwanese study published in Cancer.

Researchers led by Chia-Jen Liu, MD, of the Taipei Veterans General Hospital conducted a nationwide population-based study in Taiwan that examined 61,728 patients with newly-diagnosed colorectal cancer who underwent surgery from 2005 to 2011.

Patients were divided into four quartiles based on hospital and surgeon volume. They looked at five-year mortality rate using Cox regression, as well as short-term outcomes and resource use through multivariate regression models.

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In descending order of hospital volume quartiles, the researchers found that five-year mortality was 38.7 percent, 32.8 percent, 32 percent, and 29.1 percent. In descending order of surgeon volume quartiles, they were 41.4 percent, 34.1 percent, 29.8 percent, and 27.4 percent.

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After adjusting for individual and provider characteristics, they found that surgeon volume but not hospital volume was a significant predictor of death.

Patients who underwent definitive surgery with higher-volume surgeons had a relatively lower risk of operative mortality, shorter hospital length of stay, and lower medical expenses.

“Surgeon volume may play a more important role than hospital volume,” the authors concluded.


  1. Liu, Chia-Jen, MD, et al. “Association of surgeon volume and hospital volume with the outcome of patients receiving definitive surgery for colorectal cancer: A nationwide population-based study.” Cancer. DOI: 10.1002/cncr.29356. [epub ahead of print]. April 17, 2015.