Surgery for rectal cancer performed at teaching hospitals improves survival and preserves continence

Juan C. Gutierrez, Noor Kassira, Rabih M. Salloum, Dido Franceschi, Leonidas G. Koniaris

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


We sought to compare the outcomes of teaching and community hospitals on long-term outcomes for patients with rectal cancer. All rectal adenocarcinomas treated in Florida from 1994 to 2000 were examined. Overall, 5,925 operative cases were identified. Teaching hospitals treated 12.5% of patients with a larger proportion of regionally advanced, metastatic disease, as well as high-grade tumors. Five- and 10-year overall survival rates at teaching hospitals were 64.8 and 53.9%, compared to 59.1 and 50.5% at community hospitals (P∈=∈0.002). The greatest impact on survival was observed for the highest stage tumors: patients with metastatic rectal adenocarcinoma experienced 5- and 10-year survival rates of 30.5 and 26.6% at teaching hospitals compared to 19.6 and 17.4% at community hospitals (P∈=∈0.009). Multimodality therapy was most frequently administered in teaching hospitals as was low anterior resection. On multivariate analysis, treatment at a teaching hospital was a significant independent predictor of improved survival (hazard ratio∈=∈0.834, P∈=∈0.005). Rectal cancer patients treated at teaching hospitals have significantly better survival than those treated at community-based hospitals. Patients with high-grade tumors or advanced disease should be provided the opportunity to be treated at a teaching hospital.

Original languageEnglish (US)
Pages (from-to)1441-1450
Number of pages10
JournalJournal of Gastrointestinal Surgery
Issue number11
StatePublished - Nov 2007


  • Colon cancer
  • Disparities
  • FCDS
  • Institution
  • Outcomes
  • Survival
  • Teaching hospital

ASJC Scopus subject areas

  • Surgery


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