Cochrane · systematic review · CD005391
Workload and surgeon´s specialty for outcome after colorectal cancer surgery
Archampong, D, Borowski, D, Wille‐Jørgensen, P, et al. · Cochrane Database of Systematic Reviews · 2012 · Cochrane Library
ColorectalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
27
current version
GRADE rated
27
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 11 · 40.7%Low 16 · 59.3%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Hospital volume and primary outcomes after colorectal cancer surgery (adjusted analyses)
Population: Patients with outcomes after colorectal cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall five year survival ‐ Colorectal cancer | HR 0.9 [0.84, 0.95] | 2 studies · 36858 participants | Very low Downgraded: inconsistency |
Overall five year survival ‐ Colon cancer | HR 0.97 [0.77, 1.22] | 2 studies · 5211 participants | Very low Downgraded: risk of bias |
Overall five year survival ‐ Rectal cancer | HR 0.85 [0.77, 0.95] | 3 studies · 4028 participants | Low Downgraded: risk of bias, inconsistency |
Inpatient and 30 day mortality ‐ Colorectal cancer | OR 0.98 [0.79, 1.2] | 3 studies · 77823 participants | Very low Downgraded: inconsistency |
Inpatient and 30 day mortality ‐ Colon cancer | OR 0.89 [0.78, 1.01] | 7 studies · 263071 participants | Very low Downgraded: inconsistency |
Inpatient and 30 day mortality ‐ Rectal cancer | OR 1.07 [0.76, 1.5] | 5 studies · 14941 participants | Very low Downgraded: inconsistency |
Hospital volume and secondary outcomes after colorectal cancer surgery (adjusted analyses)
Population: Patients with outcomes after colorectal cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Five year local recurrence rate ‐ Rectal cancer | HR 0.77 [0.51, 1.16] | 3 studies · 2986 participants | Very low Downgraded: inconsistency |
Anastomotic leak rate ‐ Colon cancer | OR 1.44 [0.8, 2.59] | 1 study · 2808 participants | Low Downgraded: risk of bias, inconsistency |
Anastomotic leak rate ‐ Rectal cancer | OR 0.72 [0.48, 1.09] | 2 studies · 2615 participants | Low Downgraded: risk of bias, inconsistency |
Permanent stoma rate ‐ Rectal cancer | OR 0.57 [0.35, 0.92] | 2 studies · 7093 participants | Very low Downgraded: inconsistency |
Abdominoperineal excision of the rectum rate ‐ Rectal cancer | OR 0.55 [0.42, 0.72] | 1 study · 894 participants | Very low Downgraded: risk of bias |
Surgeon volume and primary outcomes after colorectal cancer surgery (adjusted analyses)
Population: Patients with outcomes after colorectal cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall five year survival ‐ Colorectal cancer | HR 0.87 [0.82, 0.92] | 2 studies · 15462 participants | Low Downgraded: inconsistency |
Overall five year survival ‐ Colon cancer | HR 0.84 [0.76, 0.93] | 1 study · 2905 participants | Low Downgraded: inconsistency |
Overall five year survival ‐ Rectal cancer | HR 0.99 [0.86, 1.14] | 1 study · 1903 participants | Low Downgraded: inconsistency |
Five year disease specific survival ‐ Colorectal cancer | HR 0.94 [0.78, 1.13] | 1 study · 1416 participants | Low Downgraded: inconsistency |
Inpatient and 30 day mortality ‐ Colon cancer | OR 0.79 [0.61, 1.02] | 3 studies · 47584 participants | Very low Downgraded: inconsistency |
Inpatient and 30 day mortality ‐ Rectal cancer | OR 0.79 [0.51, 1.22] | 1 study · 1903 participants | Low Downgraded: inconsistency |
Surgeon volume and secondary outcomes after colorectal cancer surgery (adjusted analyses)
Population: Patients with outcomes after colorectal cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Anastomotic leak rate ‐ Colon cancer | OR 0.66 [0.36, 1.21] | 1 study · 2570 participants | Low Downgraded: risk of bias |
Anastomotic leak rate ‐ Rectal cancer | OR 0.61 [0.29, 1.28] | 1 study · 1929 participants | Low Downgraded: risk of bias |
Permanent stoma rate ‐ Rectal cancer | OR 0.65 [0.46, 0.91] | 1 study · 1323 participants | Low Downgraded: risk of bias |
Abdominoperineal excision of rectum rate ‐ Rectal cancer | OR 0.2 [0.1, 0.4] | 1 study · 180 participants | Very low Downgraded: risk of bias |
Surgeon specialisation and primary and secondary outcomes after colorectal cancer surgery (adjusted analyses)
Population: Patients with outcomes after colorectal cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall five year survival ‐ Colorectal cancer | HR 0.81 [0.71, 0.94] | 4 studies · 14628 participants | Low Downgraded: inconsistency |
Five year disease specific survival ‐ Colorectal cancer | HR 0.74 [0.62, 0.88] | 1 study · 2186 participants | Low Downgraded: inconsistency |
Inpatient and 30 day mortality ‐ Colorectal cancer | OR 0.74 [0.6, 0.91] | 2 studies · 11973 participants | Low Downgraded: inconsistency |
Five year local recurrence rate ‐ Colorectal cancer | HR 0.56 [0.44, 0.71] | 1 study · 2587 participants | Low Downgraded: inconsistency |
Anastomotic leak rate ‐ Colorectal cancer | OR 0.71 [0.31, 1.63] | 2 studies · 8563 participants | Very low Downgraded: inconsistency |
Permanent stoma rate ‐ Rectal cancer | OR 0.7 [0.53, 0.94] | 1 study · 2026 participants | Low Downgraded: inconsistency |