Colorectal specialization and survival in XXXX .

@entity5 @entity1 @entity66 @entity14
AIM: It is recognized that higher surgeon volume is associated with improved survival in @entity14 . However, there is a paucity of national studies that have evaluated the relationship between surgical specialization and survival. METHOD: We used the Surveillance, Epidemiology, and End Results-Medicare @entity5 registry to examine the association between @entity14 ( @entity14 ) and @entity66 ( @entity66 ) between 2001 and 2009. 21,432 colon and 5,893 @entity5 @entity1 who underwent elective surgical resection between 2001 and 2009 were evaluated. Uni- and multivariate analysis Cox survival analysis was used to identify the association between surgical specialization and @entity5 -specific survival. RESULTS: Colorectal specialists performed 16.3% of the colon and 27% of the rectal resections. On univariate analysis, specialization was associated with improved survival in stage II and @entity5 and @entity5 . In multivariate analysis, however, @entity14 was associated with significantly improved @entity66 in only @entity5 (HR 0.70, p=0.03). @entity14 was not significantly associated with @entity66 in either Stage I (colon HR 1.14, p=0.39; rectal HR 0.1.26, p=.23) or Stage III (colon HR 1.06, p=0.52; rectal HR 1.08, p=.55) disease. When analysis was limited to high-volume surgeons only, the relationship between @entity14 and @entity66 was unchanged. CONCLUSIONS: Colorectal specialization is associated with improved disease specific survival following resection of @entity5 . A combination of factors may contribute to long-term survival in these @entity1 , including appropriate surgical technique, multidisciplinary treatment decisions, and guideline-adherent surveillance. Colorectal specialization likely contributes positively to these factors resulting in improved survival. This article is protected by copyright. All rights reserved.
