World Journal of Surgery最新文献

{"title":"Partial adrenalectomy by the posterior retroperitoneoscopic approach: A single institution series of 766 consecutive procedures.","authors":"Polina Knyazeva, Dmitrii Buzanakov, Pier Francesco Alesina, Martin K Walz","doi":"10.1002/wjs.12390","DOIUrl":"10.1002/wjs.12390","url":null,"abstract":"<p><strong>Background: </strong>Partial adrenalectomy (PA), as an alternative to total adrenalectomy in selected cases, allows for the preservation of adrenocortical function, especially in hereditary and/or bilateral diseases. In this study, we analyze our experience in posterior retroperitoneoscopic PA (PRPA) and its impact on adrenocortical function.</p><p><strong>Patients and methods: </strong>From January 2010 to December 2023, 709 PRPAs were performed on 766 adrenal glands in a total of 697 patients (421F; 276M; and mean age 49.3 ± 15.3). Patients suffered from all types of adrenal tumors (239 pheochromocytoma, 225 Conn's syndrome, 102 Cushing's syndrome (CS), 66 nonfunctioning adenomas, 38 adrenal metastases, and 27 others). Mean tumor size was 2.7 ± 1.5 cm. Bilateral disease occurred in 135 patients (60 pheochromocytoma, 19 Conn's syndrome, 32 CS, 2 nonfunctioning adenomas, 17 adrenal metastases, and 5 combined diseases).</p><p><strong>Results: </strong>Mean operating time for unilateral operation was 39.2 ± 17.2 min. Minor postoperative complications were observed in 1.5% and major complications in 0.1%. The median hospital stay was 2 days. In bilateral cases, 18 of 33 (54%) Cushing patients and nine of 102 (9%) non-Cushing patients received corticosteroid replacement therapy (CRT) early postoperatively. Long-term follow-up data were collected for 242 patients (35%). After unilateral surgery, only patients with CS required CRT (8/24). Eleven (24.4%) out of 45 patients with bilateral non-Cushing disease needed CRT. Eight patients (3%) developed ipsilateral recurrent disease.</p><p><strong>Conclusion: </strong>PRPA is a safe procedure with a low complication and recurrence rate. This makes it the preferred operation in cases of bilateral disease and for selected patients with benign pathologies.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological predictive factors in long-term survivors who underwent surgery for pancreatic ductal adenocarcinoma: A single-center propensity score matched analysis.","authors":"Carlo Ingaldi, Vincenzo D'Ambra, Claudio Ricci, Laura Alberici, Margherita Minghetti, Davide Grego, Virginia Cavallaro, Riccardo Casadei","doi":"10.1002/wjs.12397","DOIUrl":"https://doi.org/10.1002/wjs.12397","url":null,"abstract":"<p><strong>Background: </strong>Long-term survivors (LTSs) after pancreatic resection of pancreatic ductal adenocarcinoma (PDAC) represent a particular subgroup of patients that remains poorly understood. The primary endpoint was to identify clinicopathological factors associated with LTSs after pancreatic resection for PDAC.</p><p><strong>Methods: </strong>This was a retrospective study of patients who had undergone pancreatic resection for PDAC. Long survival was defined as a patient who survived at least 60 months. Patients were divided in two groups: LTS and short-term survivor (STS). The two groups were compared regarding epidemiological, clinical, and pathological data. Propensity score matching (PSM) was used to reduce selection bias with a 1:2 ratio. Multivariable analysis of significative predictive factors before and after PSM was done.</p><p><strong>Results: </strong>Three hundred and thirty-three patients were enrolled: 46 (13.8%) in the LTS group and 287 (86.2%) in the STS group. Using PSM, 138 patients were analyzed: 46 in the LTS group and 92 in the STS group. At the multivariate analysis of significative predictive factor after PSM, adjuvant chemotherapy, well-differentiated tumors (G1), and R0 status were related to long-term survival (p = 0.052, 0.010 and p = 0.019, respectively). Kaplan-Meier survival curves confirmed these data. Additionally, Kaplan-Meier survival curves showed that pathological stage I was a favorable factor with respect to stage II, III, and IV.</p><p><strong>Conclusions: </strong>Long-term survival is possible after pancreatic cancer resection, even if in a small percentage. Significant predictors of long-term survival are administration of adjuvant chemotherapy, American Join Committee on Cancer stage I, well-differentiated tumor (G1), and R0 resection.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine green fluorescence imaging for lymph node detection and long-term clinical outcomes in colorectal cancer surgery: A systematic review and meta-analysis.","authors":"Hong Guo, Yun Luo, Zhaojun Fu, Dengchao Wang","doi":"10.1002/wjs.12412","DOIUrl":"10.1002/wjs.12412","url":null,"abstract":"<p><strong>Background: </strong>The indocyanine green fluorescence imaging (ICG-FI) technique is increasingly being used in laparoscopic colorectal surgery for lymph node mapping. However, there is no definitive standard regarding whether the application of this technique can significantly increase the detection rate of metastatic lymph nodes and improve long-term prognosis.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library databases were searched to include studies including ICG-FI in laparoscopic colorectal surgery. Data on the detection rate of lymph nodes, metastatic rate of ICG-positive nodes, and long-term clinical outcomes were extracted following inclusion criteria.</p><p><strong>Results: </strong>Eighteen studies with a total of 1552 patients 922 with ICG-guided laparoscopic and 630 without ICG technique were finally included. Clinical stage II/III colorectal tumors were the most commonly studies types. The patients using the ICG-FI technique had more harvested lymph nodes (weighted mean: 23.5 vs. 18.9; WMD = 4.6; p < 0.00001) during dissection but a lower metastasis rate of ICG-positive nodes (61/218 [28%] vs. 96/333 [28.9%]; OR = 1.45; p = 0.08). Compared with conventional laparoscopic colorectal surgery, additional ICG-FI technique did not improve the 3 year overall survival rate (272/289 [94.1%] vs. 269/289 [93.1%]; OR = 1.19; p = 0.61), relapse-free survival (246/289 [85.1%] vs. 249/289 [86.2%]; OR = 0.92; p = 0.72), and local recurrence rate (22/289 [7.6%] vs. 28/289 [9.7%]; OR = 0.77; p = 0.38). The overall detection rate of sentinel lymph nodes, lymph flow, and metastatic rate of ICG-positive nodes with the help of ICG-FI were 86.8%, 89.9%, and 22.8%, respectively. No patients experienced major adverse events during ICG injection preoperatively or postoperatively.</p><p><strong>Conclusions: </strong>Indocyanine green fluorescence imaging-guided procedure, compared to conventional laparoscopic dissection, can assist in obtaining a greater number of harvested lymph nodes and metastatic lymph nodes, however, it did not significantly improve the long-term clinical outcomes.</p><p><strong>Level of evidence: </strong>Level III systematic review of randomized control and nonrandomized studies.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic impact of adipose tissue loss at 1 month after surgery in patients with gastric cancer.","authors":"Itaru Hashimoto, Keisuke Komori, Shizune Onuma, Hayato Watanabe, Hideaki Suematsu, Shinsuke Nagasawa, Kazuki Kano, Taiichi Kawabe, Toru Aoyama, Tsutomu Hayashi, Takanobu Yamada, Tsutomu Sato, Aya Saito, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa, Yasushi Rino, Takashi Oshima","doi":"10.1002/wjs.12370","DOIUrl":"https://doi.org/10.1002/wjs.12370","url":null,"abstract":"<p><strong>Background: </strong>The postoperative impact of short-term changes in skeletal muscle loss (SML) and adipose tissue loss (ATL) on treatment outcomes is unclear in patients with gastric cancer (GC). We investigate the role of SML and ATL at 1 month after surgery in determining postoperative survival and recurrence rates in patients with GC.</p><p><strong>Methods: </strong>We analyzed 540 patients with GC and assessed their skeletal muscle mass, visceral fat mass, and subcutaneous fat mass using computed tomography scans preoperatively and 1 month postoperatively. Patients were categorized into high and low groups based on their levels of SML, visceral ATL (v-ATL), and subcutaneous ATL (s-ATL). Additionally, they were classified into three groups (high ATL, intermediate ATL, and low ATL) based on their v-ATL and s-ATL measurements.</p><p><strong>Results: </strong>Patients with higher v-ATL and s-ATL had lower overall survival (OS) and recurrence-free survival (RFS) rates. High ATL was an independent prognostic factor for decreased OS (hazard ratio [HR] 2.27; 95% confidence interval [CI] 1.16-4.42; and P = 0.02) and RFS (HR 2.51; 95% CI 1.34-4.71; and P = 0.004) rates.</p><p><strong>Conclusion: </strong>A reduction in adipose tissue volume shortly after surgery (1 month) could potentially indicate an increased risk of recurrence and mortality in patients with GC.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of interhospital transfer on pediatric burn injury mortality in a resource-limited setting.","authors":"Sonam J Shah, Jotamu Gondwe, Selena An, Tori E Hester, Anthony Charles","doi":"10.1002/wjs.12411","DOIUrl":"https://doi.org/10.1002/wjs.12411","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization's burn mortality estimate is 180,000 annually. Ninety-five percent of all mortality caused by fire-related burns worldwide occurs in low- and middle-income countries (LMICs). Prior studies have shown that transfer status (direct transfer from an injury scene to a trauma center vs. indirect transfer from another health facility) affects patient outcomes. We evaluated the effect of interhospital transfer on burn mortality.</p><p><strong>Methods: </strong>We analyzed a burn database of pediatric patients admitted to the Kamuzu Central Hospital (KCH) burn unit in Lilongwe, Malawi. We performed a bivariate analysis based on their transfer status and mortality and a logistic regression analysis to determine the effect of transfer status on mortality after burn injury.</p><p><strong>Results: </strong>A total of 2301 patients were analyzed, with 1095 (47.6%) being in the transfer cohort from referring hospitals. The median age was 3 years (IQR 1-4). The transfer cohort had more patients presenting to the hospital more than 48 h after injury. Upon multivariate logistic regression, controlling for pertinent variables, including time to presentation, burn-injured patients in the transfer cohort had increased odds of mortality (OR 2.26, 95% CI 1.22-4.19, and p = 0.01) compared to patients who were not transferred. The predictive probabilities of burn mortality by TBSA showed significant differences in mortality based on transfer status at TBSA between 20% and 80%.</p><p><strong>Conclusion: </strong>Ensuring district hospitals and other primary health care centers in resource-limited settings are sufficiently equipped to provide initial burn resuscitation and care may decrease mortality rates associated with transferred patients.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A causal model for predicting the impact of pharmacotherapy on colorectal surgery outcomes.","authors":"Camron Sohn, John Roberts, Edson Jean-Jacques, Richard H Parrish","doi":"10.1002/wjs.12387","DOIUrl":"https://doi.org/10.1002/wjs.12387","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence-based principles in enhanced recovery programs (ERPs) demonstrate substantial improvement in patient outcomes. Determining which latent variables predict composite outcomes could refine ERP pharmacotherapy recommendations.</p><p><strong>Methods: </strong>Using R, pharmacotherapy data were modeled from an existing dataset of adult elective colorectal surgery patients. Primary composite outcome was absence of surgical site infection, venous thromboembolism, postoperative nausea and vomiting, and other in-hospital postoperative complications (POCs). Secondary composite outcome included no postdischarge POCs, hospital length of stay ≤3 days, and no readmission at 7- or 30-days.</p><p><strong>Results: </strong>Variables with greater odds of predicting both positive primary and secondary composite outcomes included prehospital oral iron and oral antibiotic use, postoperative sugammadex and neostigmine use, postoperative morphine milligram equivalents (MME) ≤ 50, and IV fluid stop by postoperative day 2. Preoperative scopolamine patch (OR = 0.29 and CI = -0.19-0.77) and perioperative gabapentin (OR = 0.46 and CI = 0.06-0.83) had lesser odds for both primary and secondary composite outcomes. Ketamine nonanesthetic bolus, ondansetron IV use, and in-hospital enoxaparin use had paradoxical lesser primary but greater odds for secondary composite outcomes. Prehospital oral laxative use (OR = 0.61 and CI = 0.18-1.04) and postoperative dual IV antibiotics (OR = 0.52 and CI = 0.10-0.94) had lesser odds for primary, but not secondary, outcome.</p><p><strong>Conclusion: </strong>To improve the odds for positive composite outcomes, oral iron and antibiotics, sugammadex and neostigmine, lower MME, and early IV fluid cessation could be considered essential core items, whereas postoperative dual IV antibiotics and epidural anesthesia might be avoided. Additional research needs to clarify the impacts of in-hospital enoxaparin, ketamine nonanesthetic bolus, and ondansetron use on composite patient outcomes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymph node yield independently predicts local recurrence in papillary thyroid cancer.","authors":"Zihao M Yang, Alexander Papachristos, Anthony J Gill, Ahmad M Aniss, Mark Sywak, Stan Sidhu","doi":"10.1002/wjs.12395","DOIUrl":"https://doi.org/10.1002/wjs.12395","url":null,"abstract":"<p><strong>Background: </strong>Lymph node yield (LNY) is a validated quality control parameter in colorectal cancer surgery, with >12 nodes reflecting an adequate oncological resection. No formal guidelines exist in the context of central and lateral compartment lymph node dissection for papillary thyroid cancer (PTC). This study aimed to investigate the association between LNY and regional recurrence in PTC patients, and to define a threshold LNY that indicates adequate compartmental lymphadenectomy.</p><p><strong>Methods: </strong>A retrospective analysis of patient data (1992-2022) was conducted using \"The University of Sydney Endocrine Surgery Unit\" database. Patients undergoing either prophylactic or therapeutic dissection of the central compartment or therapeutic dissection of the lateral compartment for PTC were included. Multivariate logistic regression analysis was performed to examine the relationship between nodal yield and local recurrence.</p><p><strong>Results: </strong>On multivariate analysis, a central LNY ≤3 was an independent adverse prognostic factor for central recurrence (odds ratios [OR] 2.19, 95% confidence intervals [CI] 1.15-4.17, and p = 0.018) and a lateral LNY ≤20 was independently predictive of lateral recurrence (OR 2.45, 95% CI 1.24-5.31, and p = 0.007).</p><p><strong>Conclusions: </strong>This study highlights the association between LNY and local recurrence in PTC. Our findings suggest that minimum LNY thresholds (>3 for central and >20 for lateral) may serve as indicators of adequate dissection. Further research should validate these findings across healthcare centers.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with symptomatic cholelithiasis at a safety net hospital: Early surgeon involvement matters.","authors":"Jasmine Guliani, Rachel I Bartelson, Fareeda Eraky, Shyamin Mehra, Nina E Glass, Nisha Narula","doi":"10.1002/wjs.12399","DOIUrl":"https://doi.org/10.1002/wjs.12399","url":null,"abstract":"<p><strong>Background: </strong>Gallstones are a common diagnosis in the United States; though many patients remain asymptomatic, others develop symptoms. Standard of care for symptomatic cholelithiasis is cholecystectomy, but many do not undergo surgery. The purpose of this study is to identify factors that influence receipt of cholecystectomy for symptomatic cholelithiasis at a safety net hospital.</p><p><strong>Methods: </strong>This is a retrospective study performed at a large, academic, tertiary care and safety net state hospital. Patients who presented with symptomatic cholelithiasis were included. Same admission cholecystectomy and elective outpatient cholecystectomy were considered success/standard of care, and readmission cholecystectomy or no cholecystectomy were considered failures/not standard of care.</p><p><strong>Results: </strong>Of 376 patients, a substantial minority were Spanish speaking, and almost half had public insurance. 23.7% were successfully treated, and 76.3% had failure in management. A larger number of patients in the group that had successful treatment had surgery consultation, 67.4%. Only 28.5% of patients saw a surgeon as an outpatient within 30 days of their visit. On multivariable analysis, patients who were provided a surgery consultation were more likely to receive standard of care. Age, sex, language, smoking status, lack of insurance, and alcohol use were not associated.</p><p><strong>Conclusion: </strong>Surgery consultation during presentation for symptomatic cholelithiasis was associated with receipt of same admission, or outpatient elective cholecystectomy, or successful management. There should be a low threshold to involve a surgeon for symptomatic cholelithiasis.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An evaluation of the Hawthorne effect in a clinical trial of trauma care in Ghana.","authors":"Adam Gyedu, Forster Amponsah-Manu, Samuel Mensah, Peter Donkor, Charles Mock","doi":"10.1002/wjs.12410","DOIUrl":"https://doi.org/10.1002/wjs.12410","url":null,"abstract":"<p><strong>Introduction: </strong>Hawthorne effect refers to changes in clinician behavior in response to being observed. It has been minimally evaluated in trauma and surgical research, especially in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>We used data from the first (control) phase of a randomized clinical trial in Ghana (2020-21). Trained observers were stationed in emergency units in eight non-tertiary hospitals to observe the achievement of key performance indicators (KPI) (KPIs) of trauma care. We hypothesized that the observers' presence would create a Hawthorne effect, resulting in clinicians (doctors, nurses) performing above their usual level, with performance highest immediately after the observers were introduced, and with performance then declining over time toward the usual baseline.</p><p><strong>Results: </strong>We enrolled 2067 injured patients. Achievement of 13 out of 16 KPIs declined significantly over the 14 months after the introduction of observers. For example, airway assessment declined from 77% initially to 60% at the end of the phase (p < 0.001). Chest examination declined from 66% to 31% (p < 0.001). Distal pulses checked declined from 45% to 7% (p < 0.001). The slope of decline in KPI achievement ranged from 0.8%/month (mobility assessed) to 15.9%/month (distal pulses checked).</p><p><strong>Conclusions: </strong>The decline in KPI achievement over time is consistent with the hypothesis that clinicians performed above their usual level just after the observers were introduced, with performance then declining toward the usual baseline. This study is among the first to provide quantitative data on the Hawthorne effect for trauma research in LMICs. These data are useful for the design of future observational studies and clinical trials.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of commission on cancer accreditation with receipt of guideline-concordant care and survival among patients with colon cancer.","authors":"Kelley Chan, Bryan E Palis, Joseph H Cotler, Lauren M Janczewski, Ronald J Weigel, David J Bentrem, Clifford Y Ko","doi":"10.1002/wjs.12391","DOIUrl":"https://doi.org/10.1002/wjs.12391","url":null,"abstract":"<p><strong>Background: </strong>Guideline-concordant care (GCC) is associated with improved survival for patients with cancer; however, variations in receipt of GCC remain a concern. The objective of this study was to evaluate the association of Commission on Cancer (CoC) hospital accreditation status with receipt of GCC and survival among patients with colon cancer.</p><p><strong>Methods: </strong>This retrospective observational study identified patients diagnosed with stage I-IV colon cancer from 2018 to 2020 from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program Database. Guideline concordance was defined as receipt of stage-appropriate lymphadenectomy or chemotherapy. Multivariable logistic regression models investigated associations with receipt of GCC. Cox proportional hazards regression models assessed 3-year cancer-specific mortality risk.</p><p><strong>Results: </strong>Of 222,583 patients with colon cancer, 146,629 (91.2%) of eligible patients received guideline-concordant lymphadenectomy and 70,586 (81.9%) of the eligible patients received guideline-concordant chemotherapy. Treatment at CoC-accredited hospitals was the strongest modifiable predictor for receipt of guideline-concordant lymphadenectomy (odds ratio [OR] 1.82; 95% confidence interval [CI] 1.75-1.88) and chemotherapy (OR 2.14; 95% CI 2.06-2.23). Among patients treated at CoC-accredited hospitals, risk adjusted mortality was decreased for patients with stage I-II disease (hazard ratio [HR] 0.94; 95% CI 0.80-0.99), stage III disease (HR 0.93; 95% CI 0.88-0.98), and stage IV disease (HR 0.88; 95% CI 0.84-0.92).</p><p><strong>Conclusions: </strong>For patients with colon cancer, treatment at CoC-accredited hospitals was associated with increased receipt of GCC and decreased mortality risk. Benchmarking data may serve as a valuable accountability tool for quality assessment to improve cancer treatment and outcomes.</p>","PeriodicalId":23926,"journal":{"name":"World Journal of Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}