Better Colorectal Cancer Surgery Outcomes with Higher-Volume Providers

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.

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.

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.

Reference

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.