Fenton, HM orcid.org/0000-0001-7824-2614, Taylor, JC orcid.org/0000-0002-2518-5799, Lodge, JPA et al. (4 more authors) (2019) Variation in the Use of Resection for Colorectal Cancer Liver Metastases. Annals of Surgery, 270 (5). pp. 892-898. ISSN 0003-4932
Abstract
Objective: The aim of this study was to investigate variation in the frequency of resections for colorectal cancer liver metastases across the English NHS.
Background: Previous research has shown significant variation in access to liver resection surgery across the English NHS. This study uses more recent data to identify whether inequalities in access to liver resection still persist.
Methods: All adults who underwent a major resection for colorectal cancer in an NHS hospital between 2005 and 2012 were identified in the COloRECTal cancer data Repository (CORECT-R). All episodes of care, occurring within 3 years of the initial bowel operation, corresponding to liver resection were identified.
Result: During the study period 157,383 patients were identified as undergoing major resection for a colorectal tumor, of whom 7423 (4.7%) underwent ≥1 liver resections. The resection rate increased from 4.1% in 2005, reaching a plateau around 5% by 2012. There was significant variation in the rate of liver resection across hospitals (2.1%–12.2%). Patients with synchronous metastases who have their primary colorectal resection in a hospital with an onsite specialist hepatobiliary team were more likely to receive a liver resection (odds ratio 1.22; 95% confidence interval, 1.10–1.35) than those treated in one without. This effect was absent in resection for metachronous metastases.
Conclusions: This study presents the largest reported population-based analysis of liver resection rates in colorectal cancer patients. Significant variation has been observed in patient and hospital characteristics and the likelihood of patients receiving a liver resection, with the data showing that proximity to a liver resection service is as important a factor as deprivation.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2019, The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | colorectal cancer, liver metastases, liver resection |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) > Trans Anaesthetics & Surgical Sciences (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Epidemiology and Biostatistics (Leeds) |
Funding Information: | Funder Grant number Yorkshire Cancer Research L394 Cancer Research UK C23434/A23706 |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 May 2019 14:08 |
Last Modified: | 19 Nov 2019 18:24 |
Status: | Published |
Publisher: | Lippincott, Williams & Wilkins |
Identification Number: | 10.1097/SLA.0000000000003534 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:146450 |
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