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Does commission on cancer (CoC) accreditation mitigate the effect of care fragmentation on clinical outcome in localized rectal cancer?
Park, Simon S; Verm, Raymond A; Abdelsattar, Zaid M; Kramer, Sarah; Swanson, James; Fernando, Mitchel; Cohn, Tyler; Luchette, Frederick A; Baker, Marshall S.
Affiliation
  • Park SS; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
  • Verm RA; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA.
  • Abdelsattar ZM; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA; Department of Surgery, Edward Hines Jr. Veterans Administration Hospital, Hines, IL, USA; Department of Thoracic and Cardiovascular Surgery, Loyola University Medical Center, Maywood, IL, USA.
  • Kramer S; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
  • Swanson J; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
  • Fernando M; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
  • Cohn T; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA.
  • Luchette FA; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA; Department of Surgery, Edward Hines Jr. Veterans Administration Hospital, Hines, IL, USA.
  • Baker MS; Department of Surgery, Loyola University Medical Center, Maywood, IL, USA; Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA; Department of Surgery, Edward Hines Jr. Veterans Administration Hospital, Hines, IL, USA; Department of Surgery, Huntsman Cancer Institute, University of
Am J Surg ; 230: 63-67, 2024 Apr.
Article in En | MEDLINE | ID: mdl-38148258
ABSTRACT

BACKGROUND:

Studies of fragmented care (FC) in rectal cancer have not adjusted for indicators of hospital quality and may misrepresent the effects of FC.

METHODS:

We queried the National Cancer Database to identify patients undergoing care for clinical stage II and III rectal adenocarcinoma between 2006 and 2019. Those undergoing FC were sub-categorized based on whether (FC CoC) or not (FC non-CoC) they received systemic therapy at CoC accredited facilities.

RESULTS:

44,339 patients met inclusion criteria; 23,921 (54 â€‹%) underwent FC, 16,929 (71 â€‹%) FC non-CoC. Differences in utilization of neoadjuvant therapy (92.3 â€‹% vs 89.7 â€‹% vs 89.5 â€‹%, p â€‹< â€‹0.01) and 5-year overall survival (76.1 vs 75.5 vs 74.1 %, p â€‹< â€‹0.01) between treatment cohorts were marginal.

CONCLUSION:

In patients undergoing multimodality therapy for rectal cancer, care fragmentation is not associated with long-term clinical outcome. Decisions regarding where these patients go for systemic therapy may be safely made on the basis of ease of access.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rectal Neoplasms Limits: Humans Language: En Journal: Am J Surg Year: 2024 Type: Article Affiliation country: United States
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Rectal Neoplasms Limits: Humans Language: En Journal: Am J Surg Year: 2024 Type: Article Affiliation country: United States