ArticleSurgery today2026
Impact of hospital volume on laparoscopic surgery for locally advanced rectal cancer: a subanalysis of the JSLCS multicenter observational study.
Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study assessed whether institutional case volume influences the short- and long-term outcomes following laparoscopic surgery for LARC in a nationwide Japanese cohort.
methodsPatients who underwent laparoscopic surgery for clinical stage II/III rectal cancer between 2010 and 2011 at 55 centers were analyzed. Hospitals were categorized as higher-volume (HVHs) or lower-volume (LVHs). Mixed-effects models adjusted for 13 clinical and demographic variables estimated the adjusted odds ratios (aORs) for postoperative complications and adjusted hazard ratios (aHRs) for the 5-year relapse-free survival (RFS) and overall survival (OS).
resultsAmong the 571 patients, 271 underwent surgery at nine HVHs and 300 at 46 LVHs. HVHs had significantly fewer postoperative complications (23.6% vs. 35.3%; aOR 0.52, 95% confidence interval [CI] 0.32-0.85, p = 0.009), shorter operation times (p = 0.013), and lower blood loss (p = 0.018). The 5-year RFS and OS rates were comparable between the groups (RFS: 65.3% and 63.5%; and OS: 80.6% and 81.0%), with no significant differences after adjustment (RFS: aHR 1.02, 95% CI 0.75-1.39, p = 0.909; OS: aHR 1.15, 95% CI 0.74-1.79, p = 0.529).
conclusionA higher hospital volume was associated with better short-term outcomes of laparoscopic surgery for LARC, whereas no significant association was observed between hospital volume and long-term oncological outcomes.
trial registrationThis study was registered in the UMIN Clinical Trials Registry System (UMIN000013919).
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