Hospital surgical volume and colorectal cancer survival in Norway: A nationwide cohort study |
| |
| Affiliation: | 1. Department of Registration, Cancer Registry of Norway, P.O. Box 5313 Majorstuen, N-0304 Oslo, Norway;2. Department of Oncology, Oslo University Hospital, P.O. Box 4950 Nydalen, 0424 Oslo, Norway;1. Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK;2. Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK;3. Nuffield Department of Population Health, University of Oxford, Oxford, UK;4. Department of Breast Surgery, St James’s University Hospital, Leeds, UK;5. National Cancer Registration and Analysis Service, NHS Digital, 2nd Floor, 23 Stephenson Street, Birmingham, UK;1. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA;2. Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA;3. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA;1. Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;2. Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt;1. Brown School, Washington University in St. Louis, St. Louis, MO, USA;2. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA;3. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA;4. Rollins School of Public Health, Emory University, Atlanta, GA, USA;1. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA;2. Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA;1. Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA;2. Division of Oncology, Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, PA, USA;3. Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA;4. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA |
| |
| Abstract: | BackgroundStudies of hospital surgical volume and colorectal cancer survival are inconclusive. We investigated whether surgical volume was associated with survival of patients operated for colorectal cancer in Norway.MethodsUsing Cancer Registry of Norway data, we compared excess mortality from colorectal cancer by hospital surgical volume among 26,989 colon and 9779 rectal cancer patients diagnosed 2009–2020 and followed-up to 31.12.2021. Hospitals were divided into terciles according to their three-year average annual surgical volume; colon: low (< 22), middle (22–73), high (> 73); rectal: low (< 17), middle (17–38), high (> 38). We estimated excess hazard ratios (EHR) with flexible parametric models adjusted for age, year, stage, surgical urgency and surgery location (within/outside patient’s residential health trust).ResultsLow-volume hospitals had the highest proportion of late-stage or acutely operated colon cancer patients. Colon cancer patients operated at low- versus high-volume hospitals had significantly increased crude excess mortality (EHR = 1.30; 95 % CI = 1.14–1.48) but no difference after adjustment for age, year, and stage (EHR = 0.97; 0.85–1.11). High-volume hospitals had the highest proportion of late-stage rectal cancer patients and patients operated outside their residential area. Rectal cancer patients operated at low- versus high-volume hospitals did not have significantly different excess mortality before (EHR = 0.84; 0.64–1.10) or after (EHR = 1.03; 0.79–1.35) adjustment for age, year, stage, surgical urgency and surgery location. After accounting for case-mix, hospital surgical volume was not associated with excess mortality from colon (P = 0.40) or rectal cancer (P = 0.22).ConclusionLow hospital surgical volume was not associated with poorer colorectal cancer survival. |
| |
| Keywords: | Colorectal Neoplasms Surgical procedures Operative Hospitals Survival |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
