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 journalArticle

13 Citations (Scopus)

Abstract

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
Pages (from-to)1441-1450
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number11
DOIs
StatePublished - Nov 1 2007

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Rectal Neoplasms
Teaching Hospitals
Survival
Community Hospital
Adenocarcinoma
Survival Rate
Neoplasms
Multivariate Analysis
Therapeutics

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Surgery for rectal cancer performed at teaching hospitals improves survival and preserves continence. / Gutierrez, Juan C.; Kassira, Noor; Salloum, Rabih M.; Franceschi, Dido; Koniaris, Leonidas G.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 11, 01.11.2007, p. 1441-1450.

Research output: Contribution to journalArticle

Gutierrez, Juan C. ; Kassira, Noor ; Salloum, Rabih M. ; Franceschi, Dido ; Koniaris, Leonidas G. / Surgery for rectal cancer performed at teaching hospitals improves survival and preserves continence. In: Journal of Gastrointestinal Surgery. 2007 ; Vol. 11, No. 11. pp. 1441-1450.
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