[Is the surgeon a prognostically relevant factor after R0-resection of colorectal carcinoma?].
Although the principles of resection of colorectal carcinoma have been defined quite exactly, some studies report considerable variations in recurrence rate and survival between different surgeons and clinics. We have therefore evaluated whether this surgeon-related influence can be found within one surgical department if operative procedures are strictly standardized. The data of 651 patients who underwent R0-resection of colorectal carcinoma between 1980 and 1992 was evaluated. Since all resections were accomplished by 5 groups of surgeons who strictly obeyed the same principles of resection, patients were divided in 5 groups. These 5 groups showed similar distribution of age, sex, tumor location, operative procedures and UICC-tumor-stages. The locoregional recurrence rate ranged from 1.7%-13.3% in stage I (p > 0.05), 9.3-20.6% in stage II (p > 0.05) and 13.6-52.4% in stage III (p < 0.05). Metachronous distant metastases occurred in 3.2 to 13.3% in stage I (p > 0.05), 2.9 to 16.7% in stage II (p > 0.05) and 21.8 to 30.2% in stage III (p > 0.05). 5-year-survival-rates of the 5 groups of patients varied from 74.4-84.5% in stage I (p > 0.05), 61.6-76.8% in stage II (p > 0.05), and 38.1 to 57.7% in stage III (p < 0.05). Although the surgeon-related variability of these results was surprisingly high, multivariate analysis did not show the surgeon as a significant prognostic factor. If the same principles of resection are strictly obeyed within one department of surgery, the surgeon is not a factor of prognostic significance.(ABSTRACT TRUNCATED AT 250 WORDS)
Schwenk
W
W
Abteilung für Chirurgie, Marien-Hospital Düsseldorf.
Hucke
H P
HP
Graupe
F
F
Stock
W
W
D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003082:Colectomy / Q000379:methods; D003106:Colon / Q000473:pathology; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D010348:Patient Care Team; D012007:Rectum / Q000473:pathology; D015996:Survival Rate
Ist der Chirurg ein prognostisch relevanter Faktor nach R0-Resektion colorectaler Carcinome?