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Published online: 2021-08-20
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The surgical treatment of the rectal cancer in Poland. The findings of the multicenter observational study of the Polish Society of Surgical Oncology (PSSO 01)

Andrzej Rutkowski, Michał Jankowski, Wojciech Zegarski, Adam Majewski, Marcin Zeman, Marek Mądrecki, Wojciech Woźny, Wiesław Kruszewski, Grzegorz Celban, Józef Kładny, Zbigniew Lorenc, Bartosz Kapturkiewicz, Marek Bębenek, Mirosław Szura, Wojciech Wysocki, Dawid Murawa, Wojciech Polkowski, Stanisław Głuszek, Józef Wróbel, Tomasz Olesiński
DOI: 10.5603/NJO.a2021.0050

open access

Ahead of print
Original article
Published online: 2021-08-20

Abstract

Introduction. PSSO-01, a Polish prospective multicenter project on rectal cancer, started in 2016 with participation on a voluntary basis. This study evaluates the early outcome of the surgical treatment of rectal cancer in Poland according to hospital volume.

Material and methods. The dataset derives from 17 clinical centers registered in the PSSO-01 study. From 2016 to 2020, data of 1,607 patients were collected. Taking into account the number of patients enrolled in the study, the centers were divided into three categories: high volume, medium volume, and low volume. Nominal variables were compared between different categories of centers using the chi-square test. The STROBE guidelines were used to guarantee the reporting of this observational study.

Results. More patients with metastatic disease were operated on in the low volume centers (p = 0.020). The neoadjuvant treatment was used in 35% , 52%, and 66% of patients operated on in low, medium, and high volume centers respectively (p < 0.001). The laparoscopic resection in medium volume centers was performed often than in other centers (p < 0.001). The total rate of postoperative complications related to high, medium, and low centers was 22%, 26%, 18% (p = 0.044).  One year following surgery, a stoma was present in 63% of patients. The defunctioning stoma following anterior resection was reversed in only 55% of patients. Anastomotic leakage was the main reason of non-reversal diverting stoma.

Conclusions. Representation of low volume centers in PSSO-01 study was understated. However, the outcomes may show the actual situation of surgical treatment of rectal cancer in high and medium volume centers in Poland.

Abstract

Introduction. PSSO-01, a Polish prospective multicenter project on rectal cancer, started in 2016 with participation on a voluntary basis. This study evaluates the early outcome of the surgical treatment of rectal cancer in Poland according to hospital volume.

Material and methods. The dataset derives from 17 clinical centers registered in the PSSO-01 study. From 2016 to 2020, data of 1,607 patients were collected. Taking into account the number of patients enrolled in the study, the centers were divided into three categories: high volume, medium volume, and low volume. Nominal variables were compared between different categories of centers using the chi-square test. The STROBE guidelines were used to guarantee the reporting of this observational study.

Results. More patients with metastatic disease were operated on in the low volume centers (p = 0.020). The neoadjuvant treatment was used in 35% , 52%, and 66% of patients operated on in low, medium, and high volume centers respectively (p < 0.001). The laparoscopic resection in medium volume centers was performed often than in other centers (p < 0.001). The total rate of postoperative complications related to high, medium, and low centers was 22%, 26%, 18% (p = 0.044).  One year following surgery, a stoma was present in 63% of patients. The defunctioning stoma following anterior resection was reversed in only 55% of patients. Anastomotic leakage was the main reason of non-reversal diverting stoma.

Conclusions. Representation of low volume centers in PSSO-01 study was understated. However, the outcomes may show the actual situation of surgical treatment of rectal cancer in high and medium volume centers in Poland.

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Keywords

rectal cancer; surgery; volume center; stoma

About this article
Title

The surgical treatment of the rectal cancer in Poland. The findings of the multicenter observational study of the Polish Society of Surgical Oncology (PSSO 01)

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Research paper (original)

Published online

2021-08-20

DOI

10.5603/NJO.a2021.0050

Keywords

rectal cancer
surgery
volume center
stoma

Authors

Andrzej Rutkowski
Michał Jankowski
Wojciech Zegarski
Adam Majewski
Marcin Zeman
Marek Mądrecki
Wojciech Woźny
Wiesław Kruszewski
Grzegorz Celban
Józef Kładny
Zbigniew Lorenc
Bartosz Kapturkiewicz
Marek Bębenek
Mirosław Szura
Wojciech Wysocki
Dawid Murawa
Wojciech Polkowski
Stanisław Głuszek
Józef Wróbel
Tomasz Olesiński

References (15)
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