title: Prospective multicenter registration study of colorectal cancer: significant variations in radicality and oncosurgical quality-Swiss Group for Clinical Cancer Research Protocol SAKK 40/00.
abstract: OBJECTIVE
  This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers.
  
  
  METHODS
  One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204).
  
  
  RESULTS
  The following variations of median values or percentages between centers were found: length of bowel specimen 20-39 cm (25.8 cm), maximum height of mesocolon 6.5-12.5 cm (9.0 cm), number of examined lymph nodes 9-24 (16), distance to nearer bowel resection margin in colon cancer 4.8-12 cm (7 cm), and in rectal cancer 2-3 cm (2.5 cm), central ligation of major artery 40-97 % (71 %), blood loss 200-500 ml (300 ml), need for perioperative blood transfusion 5-40 % (19 %), tumor opened during mobilization 0-11 % (5 %), T4-tumors not en-bloc resected 0-33 % (4 %), inadvertent perforation of mesocolon/mesorectum 0-8 % (4 %), no-touch isolation technique 36-86 % (67 %), abdominoperineal resection for rectal cancer 0-30 % (17 %), rectal cancer specimen with circumferential margin ≤1 mm 0-19 % (10 %), in-hospital mortality 0-6 % (2 %), anastomotic leak or intra-abdominal abscess 0-17 % (7 %), re-operation 0-17 % (8 %).
  
  
  CONCLUSIONS
  In colorectal cancer, surgery considerable variations between different centers were found with regard to radicality and oncosurgical quality, suggesting a potential for targeted improvement of surgical technique.
authors.affiliation: Departments of Surgery of Hospital of Liestal, Liestal, Switzerland. christoph.maurer@hin.ch.|Hirslanden Group, Clinic Beau-Site, Schänzlihalde 11, 3000, Bern, Switzerland. christoph.maurer@hin.ch.
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Maurer
authors.affiliation: Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dietrich
authors.affiliation: University Hospital of Homburg/Saar (DE), Homburg, Germany.
authors.forename: Martin K
authors.initials: MK
authors.lastname: Schilling
authors.affiliation: Triemli Hospital of Zürich, Zürich, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Metzger
authors.affiliation: Hospital of Biel, Biel, Switzerland.
authors.forename: Urban
authors.initials: U
authors.lastname: Laffer
authors.affiliation: Waid Hospital of Zürich, Zürich, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Buchmann
authors.affiliation: Hospital of Zug, Zug, Switzerland.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lerf
authors.affiliation: Hospital of of Chur, Chur, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Villiger
authors.affiliation: Hospital of of Uster, Uster, Switzerland.
authors.forename: Gian
authors.initials: G
authors.lastname: Melcher
authors.affiliation: Hospital of of Aarberg, Aarberg, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Klaiber
authors.affiliation: Hospital of Ilanz, Ilanz, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Bilat
authors.affiliation: Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Brauchli
authors.affiliation: Institute of Pathology, University of Basel, Basel, Switzerland.
authors.forename: Luigi
authors.initials: L
authors.lastname: Terracciano
authors.affiliation: Departments of Surgery of Hospital of Liestal, Liestal, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Kessler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000453:epidemiology; D012042:Registries; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
keywords: Cancer; Colorectal; Pathology; Quality; Radicality; Surgery