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| |  Mortality Improved When Older Patients With Colon Cancer Opt for Specialty Surgeon: Presented at SSO By Jill Stein ST. LOUIS, Mo -- March 8, 2010 -- Older patients with stage III colon cancer who undergo a colectomy performed by a specialty-trained colorectal cancer surgeon have improved colon cancer survival compared with patients whose colectomy is performed by a general surgeon, new data show. The investigators, who presented their data on March 6 at the 2010 Society of Surgical Oncology Annual Cancer Symposium (SSO), said that they believe their study is the first in the United States to explore the relationship between health outcomes and colon cancer surgeon visits. Nader N. Hanna, MD, University of Maryland School of Medicine, Baltimore, Maryland, and colleagues analysed data in 7,526 patients (aged >=65 y) who were diagnosed with stage III colon cancer between 1997 and 2002. A propensity-matched sample included 1,488 patients. Information about the patient sample was drawn from a Medicare database. The analysis showed that surgical resection was performed by a specialty-trained colorectal surgeon in 744 patients (10%). Of these, 88% of patients were treated by a high-volume surgeon. Among patients whose colectomy was performed by a specialty-trained colorectal cancer surgeon versus a general surgeon, mortality rates were significantly lower: 23% versus 29% (P = .002), respectively, for colon cancer mortality and 38% versus 48%, respectively, for all-cause mortality (P < .001). These specialty-treated surgical patients also experienced more frequent referral to a medical oncologist in both the full sample (69% vs 61%, P < .001) and the propensity-matched sample (69% vs 64%, P = .03) and had a greater likelihood of receiving chemotherapy within 6 months of their colectomy (60% vs 52%, P < .001) in the full sample, though this difference was not significant in the propensity-matched sample (60% vs 59%, P = .63). Results also revealed a decrease in the adjusted relative risk of colon cancer-specific mortality (HR: 0.83; P = .02) and all-cause mortality (HR: 0.81, P = .02) in the full sample as well as in the propensity-matched sample (HR: 0.79, P = .03; HR: 0.84; P = .04, respectively). A reduction in the adjusted relative risk of non-colon cancer-specific mortality also was reported in the full sample (HR: 0.79, P = .02) but not in the propensity-matched sample (HR: 0.93, P = .58). Overall, the results demonstrate that there is a cancer-specific survival benefit when colectomy is performed by a specialty-trained colorectal cancer surgeon after controlling for potential confounding factors, such as patient demographic, clinical, and socioeconomic factors, Dr. Hanna said. [Presentation Title: Survival Benefit Associated With Surgery Performed by a Colorectal Cancer Surgeon in a Cohort of Older Patients With Stage III Colon Cancer. Abstract Number P202]
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