Comparing outcomes for non-metastatic rectal cancer in academic vs. community centers: A propensity-matched analysis of the National Cancer Database - 29/11/21
, Andrew D. Sparks b, Aron Simkins c, George Kim c, Matthew Ng d, Vincent J. Obias dAbstract |
Background |
Little is known regarding the impact of hospital academic status on outcomes following rectal cancer surgery. We compare these outcomes for nonmetastatic rectal adenocarcinoma at academic versus community institutions.
Methods |
The National Cancer Database (2010–2016) was queried for patients with nonmetastatic rectal adenocarcinoma who underwent resection. Propensity score matching was performed across facility cohorts to balance confounding covariates. Kaplan-Meier estimation and Cox-proportional hazards regression were used to analyze survival, other short and long-term outcomes were analyzed by way of logistic regression.
Results |
After matching, 15,096 patients were included per cohort. Academic centers were associated with significantly decreased odds of conversion and positive margins with significantly increased odds of ≥12 regional nodes examined. Academic programs also had decreased odds of 30 and 90-day mortality and decreased 5-year mortality hazard. After matching for facility volume, no significant differences in outcomes between centers was seen.
Conclusions |
No difference between academic and community centers in outcomes following surgery for non-metastatic rectal cancer was seen after matching for facility procedural volume.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Academic hospitals show with improved outcomes compared to community hospitals after surgery for non-metastatic rectal cancer. |
• | However, these improved outcomes may be solely explained by the larger procedural volume that academic centers enjoy. |
• | When matched for procedural volume, academic and community hospitals provide similar outcomes after rectal cancer surgery. |
Keywords : Rectal Cancer, Proctectomy
Plan
Vol 222 - N° 5
P. 989-997 - novembre 2021 Retour au numéro
Article précédent
- Characteristics of Gastrointestinal Stromal Tumors incidentally discovered during abdominal surgery
- Kyle J. Hitscherich, Meera Garg, Nicholas J. Petrelli, Joseph J. Bennett
- Comparison of comorbidity indices for prediction of morbidity and mortality after major surgical procedures
- Lorine Haeuser, Peter Herzog, Asha Ayub, David-Dan Nguyen, Joachim Noldus, Eugene B. Cone, Matthew Mossanen, Quoc-Dien Trinh
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