Clinical SurgeryImpact of hospital volume on quality indicators for rectal cancer surgery in British Columbia, Canada

- The impact of hospital volume on rectal cancer outcomes is explored.
- Outcomes of interest include quality indicators known to affect outcomes.
- High-volume hospitals are associated with several important quality indicators.

BackgroundThe relationship between hospital volume and patient outcomes remains controversial for rectal cancer.MethodsThis is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers performing 20 surgeries or more per year. Primary outcomes were operative and perioperative factors that have proven influence on patient outcomes.ResultsIn all, 2,081 patients had surgery for rectal cancer. Of these, 1,690 patients had surgery in an HVH and 391 had surgery in a low-volume hospital. On multivariate analysis, patients who had surgery in an HVH were more likely to have sphincter-preserving surgery, 12 or more lymph nodes removed with the tumor, neoadjuvant radiation therapy, and receive pre-operative or postoperative chemotherapy.ConclusionsFor rectal cancer patients in British Columbia, Canada, being treated at an HVH is associated with several quality indicators linked to better patient outcomes.