Contribution of surgical specialization to improved colorectal cancer survival

• Published in: British journal of surgery 2013-09, Vol.100 (10), p.1388-1395
• Main Authors: Oliphant, R., Nicholson, G. A., Horgan, P. G., Molloy, R. G., McMillan, D. C., Morrison, D. S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anastomotic Leak - mortality; Colonic Neoplasms - mortality; Colonic Neoplasms - surgery; Colorectal Surgery; Epidemiologic Methods; Female; Humans; Male; Middle Aged; Mortality - trends; Rectal Neoplasms - mortality; Rectal Neoplasms - surgery; Scotland - epidemiology; Socioeconomic Factors; Specialization; Survival Analysis; Treatment Outcome
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.9227

Background Reorganization of colorectal cancer services has led to surgery being increasingly, but not exclusively, delivered by specialist surgeons. Outcomes from colorectal cancer surgery have improved, but the exact determinants remain unclear. This study explored the determinants of outcome after colorectal cancer surgery over time. Methods Postoperative mortality (within 30 days of surgery) and 5‐year relative survival rates for patients in the West of Scotland undergoing surgery for colorectal cancer between 1991 and 1994 were compared with rates for those having surgery between 2001 and 2004. Results The 1823 patients who had surgery in 2001–2004 were more likely to have had stage I or III tumours, and to have undergone surgery with curative intent than the 1715 patients operated on in 1991–1994. The proportion of patients presenting electively who received surgery by a specialist surgeon increased over time (from 14·9 to 72·8 per cent; P