Surgeon and hospital-related risk factors in colorectal cancer

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1、Originalarticledoi:10.1111/j.1463-1318.2010.02468.xSurgeonandhospital-relatedriskfactorsincolorectalcancersurgeryF.Bra¨nnstro¨m*†,P.Jestin†‡,P.Matthiessen§andU.Gunnarsson†*DepartmentofSurgicalSciences,UppsalaUniversity,Uppsala,Sweden,†DepartmentofSurgicalSciences,KarolinskaInstitutet,Stockhol

2、m,Sweden,‡KarlstadHospital,Karlstad,Swedenand§DepartmentofSurgery,O¨rebroUniversityHospital,O¨rebro,SwedenReceived2June2010;accepted20September2010;AcceptedArticleonline26October2010AbstractAimTheaimofthisstudywastoidentifysurgeonandanyanalysismodel.Regionalhospitalshadalowerhospital-relatedf

3、actorsinawell-definedpopulation-survivalrateforrectalcancerstageIIIsurgery(HR,basedcohort;theresultsofthisstudycouldpossiblybe1.47;95%CI,1.08–2.00).usedtoimproveoutcomeincolorectalcancer.ConclusionDegreeofspecialization,surgeoncase-loadMethodDatafromthecolonic(1997–2006)andrectalandhospitalcat

4、egorycouldnotbeidentifiedasimportant(1995–2006)cancerregistersoftheUppsalaO¨rebrofactorswhendeterminingoutcomeincolorectalcancerRegionalOncologyCentrewereusedtoassess1697surgeryinthisstudy.patientswithrectaland2692withcoloniccancer.PutativeKeywordsColoncancer,rectalcancer,formalcompe-riskfacto

5、rsandtheirimpactonlong-termsurvivalweretence,caseload,hospitalcategory,long-termsurvival,evaluatedusingtheCoxproportionalhazardmodel.populationbasedResultsThedegreeofspecializationoftheoperatingWhatisnewinthispapersurgeonhadnosignificanteffectonlong-termsurvival.Whencomparingthesurgeonswiththe

6、highestdegreeofThispopulation-basedstudyis,toourknowledge,thespecialization,noncolorectalsurgeonsdemonstratedafirstofitskindonlong-termsurvivalwheremostoftheslightlylowerlong-termsurvivalforrectalcancerstageIdataareobtainedfromtheperiodaftertotalmesorectalandII(HR,2.03;95%CI,1.05–3.92).Surgeon

7、swithaexcision(TME)wasintroducedonalargescale.highcase-loadwerenotassociatedwithbettersurvivalinassociatedwithbetterresults,especiallywhenhospitalIntroductioncase-loadiscorrectedfor[4,5,7,15].ForrectalcancerIntheearly1980s,datashowingthatther