Despite many studies of rectal cancer outcomes, no clear relationship between hospital or surgeon volume and patient outcomes has emerged for rectal cancer.
Dr Talya Salz and Robert Sandler from North Carolina, USA characterized the effect of hospital and surgical volume on surgery type and surgical outcomes in rectal cancer through a systematic review of the literature.
The team identified 23 studies evaluating the association between hospital or surgeon volume and rectal cancer outcomes.
|Beyond immediate recovery, the effect of hospital volume may be minimal|
|Clinical Gastroenterology and Hepatology |
The team describe each study and report outcomes in terms of the effect of hospital or surgeon volume on the type of surgery performed, surgical complications, postoperative mortality, survival, and recurrence.
Hospitals and surgeons with higher caseloads appear to perform more sphincter-preserving surgeries and have lower postoperative mortality rates.
Hospital and surgeon volume appear to have no effect or a small beneficial effect on the rate of leaks, complication rates, local recurrence, overall survival, and cancer-specific survival.
The research team found that for rectal cancer, the effects of hospital volume may be stronger for more short-term outcomes.
The team noted that beyond the immediate recovery period, the effect of hospital and surgeon volume may be minimal.
Dr Salz and colleague concluded, “As more technically challenging surgeries, such as total mesorectal resection, become more widespread it will be important to evaluate the impact of hospital and surgeon volume on outcomes.”