ArticleThe British journal of surgery2024
Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study.
Article in The British journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 13 citations in OpenAlex.
- How safe is teaching of highly specialized rectal surgery? A propensity score-matched 10-year cohort study.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- How Is Colorectal Cancer Care Impacted by Global Crisis in Contrasting Healthcare Systems?-A Descriptive Study From Scotland and Switzerland During the COVID-19 Pandemic.World journal of surgery · 2026Observational
- Association Between Colorectal Cancer Screening and Survival in Patients Older Than 70 Years: Results of A National Multicenter Retrospective Study.Journal of surgical oncology · 2026Article
- Association of hospital volume with perioperative and long-term outcomes of minimally invasive thymectomy.JTCVS open · 2026Article
- Short-Term Surgical Outcomes of Curative Colorectal Resections from an Evolving Low-Volume Cancer Center in a Tier-2 City in India.Indian journal of surgical oncology · 2026Article
- Multimodal Preoperative Management of Rectal Cancer: A Review of the Existing Guidelines.Medicina (Kaunas, Lithuania) · 2025Review
- An analysis of the distribution of bone and soft tissue sarcoma diagnoses and their disparities in Southwest Germany: a multicenter approach.Frontiers in oncology · 2025Article
- Short-term surgical outcomes of rectal adenocarcinoma surgical treatment in Latin America: a multicenter, retrospective assessment in 49 centers from 12 countries.International journal of colorectal disease · 2024Observational
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9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy.
methodsRetrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018-2021). Outcomes: 30-day mortality; Clavien-Dindo grade >2 complications; removal of ≥ 12 lymph nodes; non-radical resection; neoadjuvant therapy. Quartiles of hospital volumes were classified as LOW, MEDIUM, HIGH, and VERY HIGH. Independent predictors, both overall and for rectal cancer, were evaluated using logistic regression including age, gender, AJCC stage and cancer site.
resultsLOW-volume centres reported a higher rate of severe postoperative complications (OR 1.50, 95% c.i. 1.15-1.096, P = 0.003). The rate of ≥ 12 lymph nodes removed in LOW-volume (OR 0.68, 95% c.i. 0.56-0.85, P < 0.001) and MEDIUM-volume (OR 0.72, 95% c.i. 0.62-0.83, P < 0.001) centres was lower than in VERY HIGH-volume centres. Of the 4676 rectal cancer patients, the rate of ≥ 12 lymph nodes removed was lower in LOW-volume than in VERY HIGH-volume centres (OR 0.57, 95% c.i. 0.41-0.80, P = 0.001). A lower rate of neoadjuvant chemoradiation was associated with HIGH (OR 0.66, 95% c.i. 0.56-0.77, P < 0.001), MEDIUM (OR 0.75, 95% c.i. 0.60-0.92, P = 0.006), and LOW (OR 0.70, 95% c.i. 0.52-0.94, P = 0.019) volume centres (vs. VERY HIGH).
conclusionColorectal cancer surgery in low-volume centres is at higher risk of suboptimal management, poor postoperative outcomes, and less-than-adequate oncologic resections. Centralisation of rectal cancer cases should be taken into consideration to optimise the outcomes.
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