[Influence of surgeon specialization upon the results of colon cancer surgery. Usefulness of propensity scores].
BACKGROUND
surgeon influence on colorectal cancer surgery outcomes has been repeatedly studied in the scientific literature, but conclusions have been contradictory. Here we study whether surgeon specialization is a determinant factor for outcome in these patients. The importance of propensity scores (PS) in surgical research is also studied.


METHODS
a retrospective study was performed and medical records were reviewed for 236 patients who were intervened for colon cancer in Castellon General Hospital (Spain). Cases were divided into two groups (specialist and non-specialist surgeons), and both 5-year surveillance and disease free survival were compared. Comparisons were first made with no adjustments, and then subsequently using PS analysis.


RESULTS
the initial (non-adjusted) analysis was clearly favourable for the specialist surgeon group (5-year surveillance, 64.3 vs. 79.3%, p = 0.028). After adjusting for PS no statistical significance was obtained.


CONCLUSIONS
surgeon specialization had no significant impact on patient outcome after colon cancer surgery. Propensity score analysis is an important tool in the analysis of surgical non-randomized studies, particularly when events under scrutiny are rare.
Martínez-Ramos
D
D
Servicio de Cirugía General y Digestiva. Hospital General de Castellón, Castellón, Spain. davidmartinez@comcas.es
Escrig-Sos
J
J
Miralles-Tena
J M
JM
Rivadulla-Serrano
M I
MI
Daroca-José
J M
JM
Salvador Sanchís
J L
JL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D013502:General Surgery / Q000592:standards; D006801:Humans; D008297:Male; D008511:Medicine; D008875:Middle Aged; D012189:Retrospective Studies; D013038:Specialization; D016896:Treatment Outcome