Hospital factors and metastatic surgery in colorectal cancer patients, a population-based cohort study

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Ljunggren, MalinKarolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Karolinska Univ Hosp, Med Unit Trauma Emergency Surg & Orthopaed, Stockholm, Sweden. (author)

Hospital factors and metastatic surgery in colorectal cancer patients, a population-based cohort study

Article/chapterEnglish2022

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2022-08-19
Springer Nature,2022
electronicrdacarrier

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LIBRIS-ID:oai:DiVA.org:uu-483870
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-483870URI
https://doi.org/10.1186/s12885-022-10005-8DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:150518374URI

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Language:English
Summary in:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Background: Only a limited proportion of patients with metastatic colorectal cancer (mCRC) receives metastatic surgery (including local ablative therapy). The aim was to investigate whether hospital volume and hospital level were associated with the chance of metastatic surgery.Methods: This national cohort retrieved from the CRCBaSe linkage included all Swedish adult patients diagnosed with synchronous mCRC in 2009-2016. The association between annual hospital volume of incident mCRC patients and the chance of metastatic surgery, and survival, were assessed using logistic regression and Cox regression models, respectively. Hospital level (university/non-university) was evaluated as a secondary exposure in a similar manner. Both uni- and multivariable (adjusted for sex, age, Charlson comorbidity index, year of diagnosis, cancer characteristics and socioeconomic factors) models were fitted.Results: A total of 1,674 (17%) out of 9,968 mCRC patients had metastatic surgery. High hospital volume was not associated with increased odds of metastatic surgery after including hospital level in the model, whereas hospital level was (odds ratio (OR) (95% confidence interval (CI)): 1.94 (1.68-2.24)). All-cause mortality was lower in university versus non-university hospitals (hazard ratio (95% CI): 0.83 (0.78-0.88)).Conclusions: Patients with mCRC initially cared for by a university hospital experienced a greater chance to receive metastatic surgery and had superior overall survival. High hospital volume in itself was not associated with a greater chance to receive metastatic surgery nor a greater survival probability. Additional efforts should be imposed to provide more equal care for mCRC patients across Swedish hospitals.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Cancer och onkologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cancer and Oncology hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
Colorectal neoplasms
High-volume hospitals
Low-volume hospitals
Neoplasm metastasis
Secondary
Surgery
Survival
University hospitals

Added entries (persons, corporate bodies, meetings, titles ...)

Weibull, Caroline E.Karolinska Institutet,Karolinska Inst, Dept Med, Clin Epidemiol Div, Stockholm, Sweden. (author)
Rosander, EmmaKarolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Danderyd Hosp, Dept Surg & Urol, Stockholm, Sweden. (author)
Palmer, GabriellaKarolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pelv Canc, GI Oncol & Colorectal Surg Unit, Stockholm, Sweden. (author)
Glimelius, BengtUppsala universitet,Institutionen för immunologi, genetik och patologi(Swepub:uu)bengglim (author)
Martling, AnnaKarolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pelv Canc, GI Oncol & Colorectal Surg Unit, Stockholm, Sweden. (author)
Nordenvall, CarolineKarolinska Institutet,Karolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Karolinska Univ Hosp, Dept Pelv Canc, GI Oncol & Colorectal Surg Unit, Stockholm, Sweden. (author)
Karolinska InstitutetKarolinska Univ Hosp, Karolinska Inst, Dept Mol Med & Surg, Colorectal Surg Unit, Anna Stecksens Gata 30A,D2 05, S-17176 Solna Stockholm, Sweden.;Karolinska Univ Hosp, Med Unit Trauma Emergency Surg & Orthopaed, Stockholm, Sweden. (creator_code:org_t)

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In:BMC Cancer: Springer Nature221471-2407

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

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