ArticleJournal of gastrointestinal oncology2017
Systematic review and a meta-analysis of hospital and surgeon volume/outcome relationships in colorectal cancer surgery.
Article in Journal of gastrointestinal oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
78 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Hospital and surgeon volume versus outcomes after colorectal cancer surgery: umbrella review and meta-analysis.BJS open · 2026Pooled it
- Evaluating Surgical Approaches in Early NSCLC: A Meta-Analysis of Robot-Assisted and Video-Assisted Techniques.Annals of surgical oncology · 2026Pooled it
- Volume-outcome relationship in anatomical and non-anatomical liver resections: a rapid systematic review.BMC gastroenterology · 2026Pooled it
- Volume-outcome relationship in corrective surgery for Hirschsprung's disease: a systematic literature review of direct evidence and an overview of indirect evidence.Pediatric surgery international · 2025Pooled it
- A Systematic Review and Multilevel Regression Analysis Reveals the Comorbidity Prevalence in Cancer.Cancer research · 2023Pooled it
- Postoperative morbidity and mortality after surgical resection of small bowel neuroendocrine neoplasms: A systematic review and meta-analysis.Journal of neuroendocrinology · 2021Pooled it
- Trial
- Temporal Trends in Clinical Evidence of 5-Year Survival Within Electronic Health Records Among Patients With Early-Stage Colon Cancer Managed With Laparoscopy-Assisted Colectomy vs Open Colectomy.JAMA network open · 2022Trial
- Low pectoralis major muscle mass predicts the risk of post-surgical bleeding after mastectomy in patients with breast cancer.Breast cancer research and treatment · 2026Article
- Cumulative Surgeon Experience and Anastomotic Leakage After Left-Sided and Segmental Colorectal Resection with Primary Anastomosis: A Seven-Year Single-Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2026Observational
- Short-and Long-term Patient Outcomes in Hospitals Primarily Serving Patients with Colorectal Cancer from High-Poverty Areas-An Observational Cohort Study.Annals of surgical oncology · 2026Observational
- [Centralization of liver surgery in Germany].Chirurgie (Heidelberg, Germany) · 2026Review
- Association between preoperative inflammatory biomarkers and postoperative morbidity and mortality in stage I-III colorectal cancer patients: a single-centre prospective study.BMJ connections surgery · 2026Article
- Association of early discharge and clinical outcomes following proctectomy for patients with rectal cancer: A NRD analysis.PloS one · 2026Article
- Impact of centre volume on adrenalectomy outcomes: European multicentre study based on EUROCRINE® registry.BJS open · 2025Article
- Trends in mortality, pathogen distribution, and antimicrobial resistance of peritoneal and intra-abdominal infections from 1990 to 2021: a cross-sectional analysis of the MICROBE database.International journal of surgery (London, England) · 2025Article
- Impact and evolution of minimal invasive surgery in a centralized colorectal service: trends, safety and oncological outcomes across 15 years.World journal of surgical oncology · 2025Article
- Global benchmarks for minimally invasive right hemicolectomy for cancer.The British journal of surgery · 2025Article
- Improved Survival with Improved NAPRC Compliance: A Single-Institution Experience.Journal of clinical medicine · 2025Article
- Does surgeon or hospital volume influence outcome in dedicated colorectal units?-A Viennese perspective.Wiener klinische Wochenschrift · 2025Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNumerous hospitals worldwide are considering setting minimum volume standards for colorectal surgery. This study aims to examine the association between hospital and surgeon volume on outcomes for colorectal surgery.
methodsTwo investigators independently reviewed six databases from inception to May 2016 for articles that reported outcomes according to hospital and/or surgeon volume. Eligible studies included those in which assessed the association hospital or surgeon volume with outcomes for the surgical treatment of colon and/or rectal cancer. Random effects models were used to pool the hazard ratios (HRs) for the association between hospital/surgeon volume with outcomes.
resultsThere were 47 articles pooled (1,122,303 patients, 9,877 hospitals and 9,649 surgeons). The meta-analysis demonstrated that there is a volume-outcome relationship that favours high volume facilities and high volume surgeons. Higher hospital and surgeon volume resulted in reduced 30-day mortality (HR: 0.83; 95% CI: 0.78-0.87, P<0.001 & HR: 0.84; 95% CI: 0.80-0.89, P<0.001 respectively) and intra-operative mortality (HR: 0.82; 95% CI: 0.76-0.86, P<0.001 & HR: 0.50; 95% CI: 0.40-0.62, P<0.001 respectively). Post-operative complication rates depended on hospital volume (HR: 0.89; 95% CI: 0.81-0.98, P<0.05), but not surgeon volume except with respect to anastomotic leak (HR: 0.59; 95% CI: 0.37-0.94, P<0.01). High volume surgeons are associated with greater 5-year survival and greater lymph node retrieval, whilst reducing recurrence rates, operative time, length of stay and cost. The best outcomes occur in high volume hospitals with high volume surgeons, followed by low volume hospitals with high volume surgeons.
conclusionsHigh volume by surgeon and high volume by hospital are associated with better outcomes for colorectal cancer surgery. However, this relationship is non-linear with no clear threshold of effect being identified and an apparent ceiling of effect.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.