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The surgical treatment of rectal cancer in Poland. The findings of a multi-center observational study by the Polish Society of Surgical Oncology (PSSO-01)
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Affiliations- Department of Surgical Oncology, Oncology Center – Prof Franciszek Lukaszczyk Memorial Hospital, Bydgoszcz, Poland
- Department of Gastroenterological Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Specialist Hospital of Dr. Alfred Sokolowski, Walbrzych, Poland
- The Oncologic and Reconstructive Surgery Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
- First Department of General and Oncological Surgery, Voivodeship Integrated Hospital in Plock, Plock, Poland
- First Department of General and Oncological Surgery, Voivodeship Hospital Centre of the Jelenia Gora Basin, Jelenia Gora, Poland
- Oncological Surgery Department, Gdynia Centre of Oncology, Polish Red Cross Memorial Maritime Hospital, Pomeranian Hospitals Ltd., Gdynia, Poland
- Division of Oncological Propedeutics, Medical University of Gdansk, Gdansk, Poland
- Department of Surgical Oncology, Jurassic Center of Oncology, Czestochowa, Poland
- Department of General and Oncological Surgery, Pomeranian Medical University, Szczecin, Poland
- Clinical Department of General, Colorectal and Trauma Surgery, Silesian Medical University, Sosnowiec, Poland
- Department of Surgery, Lower Silesian Oncological Centre, Wroclaw, Poland
- Department of Surgery, Institute of Physiotherapy, Faculty of Health Science, Jagiellonian University, Krakow, Poland
- Chair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
- Department of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital in Krakow, Krakow, Poland
- Scientific Editorial Office, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Chair of Surgery and Oncology, Collegium Medicum, University in Zielona Gora, Zielona Gora, Poland
- Department of General Surgery and Surgical Oncology, University Hospital in Zielona Gora, Zielona Gora, Poland
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland
- Department of General, Oncological and Endocrinological Surgery, Collegium Medicum Jan Kochanowski University in Kielce, Kielce, Poland
- Beskid Oncology Center – John Paul II Municipal Hospital, Bielsko-Biala, Poland
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Abstract
Introduction. PSSO-01, a Polish prospective multi-center 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, the 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). Neoadjuvant treatment was used in 35%, 52%, and 66% of patients operated on in low, medium, and high volume centers respectively (p < 0.001). Laparoscopic resection in medium volume centers was performed more 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. A defunctioning stoma following anterior resection was reversed in only 55% of patients. Anastomotic leakage was the main reason for a non-reversal diverting stoma.
Conclusions. The representation of low volume centers in the 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 multi-center 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, the 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). Neoadjuvant treatment was used in 35%, 52%, and 66% of patients operated on in low, medium, and high volume centers respectively (p < 0.001). Laparoscopic resection in medium volume centers was performed more 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. A defunctioning stoma following anterior resection was reversed in only 55% of patients. Anastomotic leakage was the main reason for a non-reversal diverting stoma.
Conclusions. The representation of low volume centers in the 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.
Keywords
rectal cancer; surgery; volume center; stoma
About this articleTitle
The surgical treatment of rectal cancer in Poland. The findings of a multi-center observational study by the Polish Society of Surgical Oncology (PSSO-01)
Journal
Nowotwory. Journal of Oncology
Issue
Article type
Research paper (original)
Pages
282-289
Published online
2021-08-20
Page views
6402
Article views/downloads
546
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2021;71(5):282-289.
Keywords
rectal cancer
surgery
volume center
stoma
Authors
Michał Jankowski
Andrzej Rutkowski
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 M. Wysocki
Dawid Murawa
Wojciech Polkowski
Stanisław Głuszek
Józef Wróbel
Tomasz Olesiński
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