Influence of Individual Surgeon Volume on Oncological Outcome of Colorectal Cancer Surgery

Abstract EN

Background.

Surgery performed by a high-volume surgeon improves short-term outcomes.

However, not much is known about long-term effects.

Therefore we performed the current study to evaluate the impact of high-volume colorectal surgeons on survival.

Methods.

We conducted a retrospective analysis of our prospectively collected colorectal cancer database between 2004 and 2011.

Patients were divided into two groups: operated on by a high-volume surgeon (>25 cases/year) or by a low-volume surgeon (<25 cases/year).

Perioperative data were collected as well as follow-up, recurrence rates, and survival data.

Results.

774 patients underwent resection for colorectal malignancies.

Thirteen low-volume surgeons operated on 453 patients and 4 high-volume surgeons operated on 321 patients.

Groups showed an equal distribution for preoperative characteristics, except a higher ASA-classification in the low-volume group.

A high-volume surgeon proved to be an independent prognostic factor for disease-free survival in the multivariate analysis P=0.04.

Although overall survival did show a significant difference in the univariate analysis P<0.001 it failed to reach statistical significance in the multivariate analysis P=0.09.

Conclusions.

In our study, a higher number of colorectal cases performed per surgeon were associated with longer disease-free survival.

Implementing high-volume surgery results in improved long-term outcome following colorectal cancer.