Impact of surgeon's technique on outcome after treatment of rectal carcinoma

PURPOSE: The aim of this study was to analyze the impact of institutions an d individual surgeons on long-term prognosis after curative resection of re ctal carcinoma. METHODS: We used univariate and multivariate analysis of da ta from a German prospective, multicenter, patient-care evaluation study. R ESULTS: The locoregional recurrence rates and the observed and cancer-relat ed survival rates showed a considerable interinstitutional and intersurgeon variability. Multivariate analysis confirmed the institution and the indiv idual surgeon as significant independent factors influencing locoregional r ecurrence and survival. There was a statistically highly significant correl ation between the rate of locoregional recurrence and survival rate. CONCLU SIONS: The surgeon's technique and skill has to focus on prevention of loco regional recurrence to achieve good long-term outcome after curative resect ion for rectal carcinoma. New clinical trials on adjuvant treatment have to include quality assurance for surgery and pathology and documentation of t he surgeon las local code).