Skip to main content

09.12.2015 | Original Article | Ausgabe 5/2016

Journal of Gastrointestinal Surgery 5/2016

Hospital Characteristics Associated with Stage II/III Rectal Cancer Guideline Concordant Care: Analysis of Surveillance, Epidemiology and End Results-Medicare Data

Journal of Gastrointestinal Surgery > Ausgabe 5/2016
Mary E. Charlton, Jennifer E. Hrabe, Kara B. Wright, Jennifer A. Schlichting, Bradley D. McDowell, Thorvardur R. Halfdanarson, Chi Lin, Karyn B. Stitzenberg, John W. Cromwell
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-015-3046-2) contains supplementary material, which is available to authorized users.



Evidence suggests that high-volume facilities achieve better rectal cancer outcomes.


Logistic regression was used to evaluate association of facility type with treatment after adjusting for patient demographics, stage, and comorbidities. SEER-Medicare beneficiaries who were diagnosed with stage II/III rectal adenocarcinoma at age ≥66 years from 2005 to 2009 and had Parts A/B Medicare coverage for ≥1 year prediagnosis and postdiagnosis plus a claim for cancer-directed surgery were included. Institutions were classified according to National Cancer Institute (NCI) designation, presence of residency program, or medical school affiliation.


Two thousand three hundred subjects (average age = 75) met the criteria. Greater proportions of those treated at NCI-designated facilities received transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI)-pelvis (62.1 vs. 29.9 %), neoadjuvant chemotherapy (63.9 vs. 41.8 %), and neoadjuvant radiation (70.8 vs. 46.3 %), all p < 0.0001. On multivariate analysis, odds ratios (95 % confidence intervals) for receiving TRUS or MRI, neoadjuvant chemotherapy, or neoadjuvant radiation among beneficiaries treated at NCI-designated facilities were 3.51 (2.60–4.73), 2.32 (1.71–3.16), and 2.66 (1.93–3.67), respectively. Results by residency and medical school affiliation were similar in direction to NCI designation.


Those treated at hospitals with an NCI designation, residency program, or medical school affiliation received more guideline-concordant care. Initiatives involving provider education and virtual tumor boards may improve care.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Premium-Inhalten der Fachzeitschriften, inklusive eines Print-Abos.

Weitere Produktempfehlungen anzeigen
Online only Table 1 Codes and SEER-Medicare files used to identify pre-treatment and treatment variables (DOC 40 kb)
Über diesen Artikel

Weitere Artikel der Ausgabe 5/2016

Journal of Gastrointestinal Surgery 5/2016Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.