Hospital procedure volume and teaching status do not influence treatment and outcome measures of rectal cancer surgery in a large general population

A clear benefit of increased hospital procedure volume or teaching hospital status on outcomes of rectal cancer surgery has yet to be shown. Few have examined treatment differences that may lead to varying outcomes. This stud y assessed the impact of hospital procedure volume and teaching status on b oth treatment and outcome measures of rectal cancer surgery in a large gene ral population. Data were obtained for 1072 incident cases of rectal adenoc arcinoma diagnosed in 1990 from Ontario, Canada, and treated with a major r esection. Hospitals were classified by teaching status and procedure volume . Pathology reports were examined for 418 procedures. Abdominoperineal rese ctions accounted for 31.0% of all procedures. There were no clinically sign ificant differences in treatment measures, operative mortality: and long-te rm survival among the hospital groups according to both univariate, and mul tivariate analyses. In conclusion, the absence of a hospital volume or teac hing status effect on treatment and outcome measures suggests that for rect al cancer surgery in Ontario, centralization of procedures into high-volume or teaching centers is unlikely to improve surgical quality.