Cancer Center Volume and Type Impact Stage-Specific Utilization of Neoadjuvant Therapy in Rectal Cancer

Digestive Diseases and Sciences
Emily F MiduraIan M Paquette

Abstract

Neoadjuvant chemoradiation reduces local recurrence in locally advanced rectal cancer, and adherence to national and societal recommendations remains unknown. To determine variability in guideline adherence in rectal cancer treatment and investigate whether hospital volume correlated with variability seen. We performed a retrospective analysis using the National Cancer Database rectal cancer participant user files from 2005 to 2010. Stage-specific predictors of neoadjuvant chemotherapy and radiation use were determined, and variation in use across hospitals analyzed. Hospitals were ranked based on likelihood of preoperative therapy use by stage, and observed-to-expected ratios for neoadjuvant therapy use calculated. Hospital outliers were identified, and their center characteristics compared. A total of 23,488 patients were identified at 1183 hospitals. There was substantial variability in the use of neoadjuvant chemoradiation across hospitals. Patients managed outside clinical guidelines for both stage 1 and stage 3 disease tended to receive treatment at lower-volume, community cancer centers. There is substantial variability in adherence to national guidelines in the use of neoadjuvant chemoradiation for rectal cancer across ...Continue Reading

References

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Citations

Nov 30, 2018·ANZ Journal of Surgery·Georges TinawiElizabeth R Dennett
Nov 14, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Douglas S SwordsCourtney L Scaife
Jul 31, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Mackenzie C MorrisIan M Paquette
Feb 2, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Douglas S SwordsH Tae Kim
Feb 11, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·E R M ScheepersM E Hamaker
Apr 14, 2021·Surgical Oncology·Sarah B Stringfield, James W Fleshman

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