Improved results in rectal cancer surgery—an effect of specialization?

Abstract

Concentrating the care of patients with rectal cancer to a specialized team seems to improve quality and outcome.

Impaired postoperative leucocyte counts after preoperative radiotherapy for rectal cancer in the Stockholm III Trial

“…No differences regarding missing data were seen between the treatment arms, which minimized selection bias resulting from this. Low preoperative leucocyte count after preoperative RT has been suggested to be associated with increased postoperative complications and death 6,7,9 . The present study has rejected this hypothesis.…”

“…RT also increases postoperative morbidity, however, and, in some studies, mortality. Reasons suggested for this have been an increase in systemic cytokines or depressed bone marrow resulting in preoperative leucopenia and/or impaired postoperative leucocytosis. The positive association between impaired leucocyte responses, defined as a low ratio between postoperative and preoperative leucocyte counts (LC ratio), and postoperative complications has been demonstrated previously.…”

A Systematic Overview of Radiation Therapy Effects in Rectal Cancer

“…Several individual hospitals have also reported low recurrence rates after having introduced the TME concept (e.g. (56,57)). There are also several reports pointing to the importance of the surgeon for the outcome (58,59).…”

Le mésorectum dans la chirurgie du cancer rectal : un indice de récidive pelvienne ?

“…Le taux de récidive locale est ainsi passé de 20-40 % à moins de 10 % [7][8][9][10][11][12][13]. Ainsi, les équipes ayant changé de technique pour utiliser l'ETM ont obtenu des taux de récidive locale significativement inférieurs à ceux obtenus après exérèse conventionnelle (Tableau 1).…”