Surgeons with higher technical skills saw improved long-term survival among patients with colon cancer compared with surgeons considered to have low skills.1
A study by Brajcich and colleagues looked at surgical videos submitted by 15 surgeons from 11 hospitals. The videos were of laparoscopic right hemicolectomy performed on patients with colon cancer. The videos were reviewed by 12 or more other surgeons, including 2 with video evaluation experience, and skill scores were assigned.
The researchers then looked at outcomes for the surgeons from 609 patients identified in the National Cancer Database on surgeries performed between 2012 and 2017.
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Surgeons scored as high skill had higher overall survival compared with surgeons with medium and low skill scores. The 5-year overall survival was 79% for high skill, 55% for medium skill, and 60% for low skill (P =.01 for log-rank test). Each 0.1-point skill score increment was associated with a higher likelihood of survival (hazard ratio [HR], 0.90; 95% CI, 0.84-0.97; P =.01).
“This association persists when excluding early postoperative deaths, suggesting that these findings are not solely attributable to mortality from surgical complications,” the researchers wrote.
“Skill may affect survival through oncologic resection quality (eg, lymph node harvesting) or may reflect surgeon characteristics, such as operative volume or
guideline adherence,” they wrote. “Additionally, fewer complications might reduce long-term morbidity affecting nutrition and physical function.”
Reference
Bajich BC, Stulberg, JJ, Palis BE, et al. Association between surgical technical skill and long-term survival for colon cancer. JAMA Oncol. Published online October 30, 2020. doi:10.1001/jamaoncol.2020.5462
