title: Effect of surgeon specialization on long-term survival following colon cancer resection at an NCI-designated cancer center.
abstract: BACKGROUND
  Recent studies have documented improved outcomes for patients undergoing colorectal cancer resection at NCI cancer centers compared to hospitals without this designation. Proposed contributory factors include a higher proportion of surgeons with specialty training in colorectal surgery and surgical oncology. The purpose of this study was to assess whether surgeon specialization is associated with differences in overall survival following colon cancer resection at an NCI cancer center.
  
  
  METHODS
  We conducted a retrospective review of patients undergoing colectomy for colon cancer from 1994 to 2009 at Duke University Medical Center. Patients were divided into two groups based on specialization status of the attending surgeon, and several clinicopathologic variables were compared. A multivariate analysis was then performed examining variables influencing overall survival.
  
  
  RESULTS
  Total of 395 patients were included in the study, with 335 patients operated on by specialty-trained surgeons and 60 patients operated on by non-specialists. Overall, the two groups were similar with respect to demographic and pathologic variables. On multivariate analysis, surgeon specialization was found to be an independent predictor of improved overall survival [HR 0.43 (CI: 0.25-0.75), P = 0.003].
  
  
  CONCLUSIONS
  Surgeon specialization appears to be associated with improved overall survival in the setting of an NCI-designated cancer center.
authors: Section of Colon and Rectal Surgery, Duke University Medical Center, Durham, North Carolina, USA. andrew.barbas@duke.edu
authors: Andrew S
authors: AS
authors: Barbas
authors: Ryan S
authors: RS
authors: Turley
authors: Christopher R
authors: CR
authors: Mantyh
authors: John
authors: J
authors: Migaly
mesh_terms: D000367:Age Factors; D000368:Aged; D002173:Cancer Care Facilities; D002983:Clinical Competence; D003082:Colectomy; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D054547:National Cancer Institute (U.S.); D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D013043:Specialties, Surgical; D016019:Survival Analysis; D014481:United States