Surgery for rectal cancer: Differences in resection rates among hospitals in the Netherlands

L J X Giesen*, P B Olthof, M A G Elferink, C Verhoef, J W T Dekker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
32 Downloads (Pure)

Abstract

AIM: Numerous quality improvement initiatives for rectal cancer surgery have focused on textbook outcome parameters. In these studies, resection rate and patients who did not undergo surgery are not included, but these parameters might help to evaluate the surgical care for rectal cancer. The aim of this study is to assess the variation of non-metastatic rectal cancer resection rates among hospitals and its effect on patient outcomes.

METHODS: All patients diagnosed with non-metastatic rectal cancer between 2013 and 2018 were selected from the Netherlands Cancer Registry. Hospitals were categorized in quartiles according to resection rates. A multivariable logistic analysis was performed to determine variation in resection rate between these quartiles using a logistic regression analysis to correct for confounders. The association between resection rates and survival was analyzed using Kaplan-Meier method and Cox-regression analysis.

RESULTS: A total of 22,530 patients were included in the analysis. Resection rates varied from 68 to 89% between hospitals. After multivariable analysis, resection rate remained significantly different among the quartiles when correcting for several factors (odds ratio (95%Confidence-interval) 1.71 (1.56-1.88), 2.42 (2.19-2.67), and 4.04 (3.61-4.53) for increasing resection rate quartiles, in reference to the lowest quartile). A higher resection rate was associated with better overall survival, in multivariable analysis this survival benefit could no longer be identified.

CONCLUSION: There is a substantial variation in resection rates for rectal cancer among hospitals in the Netherlands with an impact on overall survival. This may be a relevant issue when analyzing the overall quality of rectal cancer care.

Original languageEnglish
Pages (from-to)2384-2389
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume47
Issue number9
DOIs
Publication statusPublished - Sept 2021

Bibliographical note

Acknowledgements
The authors thank the registration team of the Netherlands
Comprehensive Cancer Organisation (IKNL) for the collection of
data for the Netherlands Cancer Registry as well as IKNL staff for
scientific advice.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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