Study: Mixed Finding on Colon Cancer Surgery at Small Hospitals

Colon cancer patients who have surgery at hospitals performing a relatively low number of these operations are at higher risk of dying within five years, but not from a recurrence of their colon cancer, according to Harvard researchers.

In their study of 3161 patients with high-risk stage II and stage III colon cancer, the researchers found that the five-year overall survival rate was 67.3 percent for patients who had surgery at high-volume hospitals compared to 63.8 percent for patients operated on at low-volume hospitals.

But interestingly, the researchers found that the five-year cancer recurrence-free survival rate was 63.9 percent for patients who had surgery at low-volume hospitals compared with 63.0 percent for those operated on at high-volume hospitals.

The implications of this finding, according to editors of the Annals of Internal Medicine, where the study was reported, are that "poor long-term survival in hospitals with low rates of colorectal cancer surgery may be due to the poor general health of populations cared for at low-volume hospitals rather than to low-quality cancer surgery."

"Whether differences exist in the general health status of patients, the use of preventive medicine programs, or the quality of care of non–cancer-related diseases at low-volume centers is beyond the scope of this study," the researchers reported.

But they said their findings should give pause to the growing movement toward "regionalization of cancer surgeries to improve patient outcomes."

Other sources: Annals of Internal Medicine