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07.10.2016 | Original Article | Ausgabe 1/2017

International Journal of Colorectal Disease 1/2017

Prospective multicenter registration study of colorectal cancer: significant variations in radicality and oncosurgical quality—Swiss Group for Clinical Cancer Research Protocol SAKK 40/00

Zeitschrift:
International Journal of Colorectal Disease > Ausgabe 1/2017
Autoren:
Christoph A. Maurer, Daniel Dietrich, Martin K. Schilling, Urs Metzger, Urban Laffer, Peter Buchmann, Bruno Lerf, Peter Villiger, Gian Melcher, Christian Klaiber, Christian Bilat, Peter Brauchli, Luigi Terracciano, Katharina Kessler
Wichtige Hinweise
Parts of the study results have been presented at the annual congress of the Swiss Surgical Society in Lugano, Switzerland, June 2006, at the 7. BIC Biebrich International Conference on Colorectal Cancer in Wiesbaden, Germany, October 2010, and at the annual congress of the Swiss Surgical Society in Bern, Switzerland, May 2015.
Christian Klaiber is deceased October 2013

Abstract

Purpose

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 %).

Conclusion

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.

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