Association of surgeon volume and hospital volume with the outcome of patients receiving definitive surgery for colorectal cancer: A nationwide population-based study.

摘要: BACKGROUND Patients with colorectal cancer (CRC) who undergo surgeries higher-volume providers may have better outcomes. The current debate focuses on whether it is hospital volume or surgeon that matters more. METHODS The authors conducted a nationwide population-based study in Taiwan enrolled all patients underwent definitive surgery for newly diagnosed CRC between 2005 and 2011. All were divided into 4 quartiles according to volume. main outcome was the 5-year mortality rate, which analyzed using frailty model Cox regression. also fixed random effects multivariate regression models examine short-term outcomes resource use, including operative mortality, stay, emergency department visits within 30 days, medical expenses. Analyses adjusted patient provider characteristics. RESULTS A total of 61,728 included study. rates 38.7%, 32.8%, 32.0%, 29.1% descending order 41.4%, 34.1%, 29.8%, 27.4% quartiles. After adjustment individual characteristics, volume, but not remained significantly predictive factor death (P<.001). In addition, those performed by surgeons had relatively lower risk shorter length expenses. CONCLUSIONS Patients found Surgeon play more important role than Cancer 2015;121:2782-2790. © 2015 American Society