Technically-Skilled Surgeons Improve Colon Cancer Survival by 70 Percent
A new study from Northwestern Medicine presents that patients of more technically-skilled surgeons, as evaluated by a review of the operative video, are found to have better-term survival following surgery for colon cancer treatment.
According to the study findings, "Patients whose surgery was performed by a highly-skilled surgeon" were found to have a 70-percent lower risk of dying over five years compared to those whose surgery was performed by a lower-skilled surgeon.
According to Northwestern University Feinberg School of Medicine surgery professor Dr. Karl Bilimoria, "This is pretty mind blowing." The professor, who's also a Northwestern Medicine surgical oncologist added, the long-term effect is huge.
Published on October 30 in JAMA Oncology, the said research was also presented virtually during the Commission on Cancer Annual Meeting.
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A new study from Northwestern Medicine presents that patients of more technically-skilled surgeons are found to have better-term survival following surgery for colon cancer treatment.
A Pioneering Study
Even though the essentiality of surgical skill has long been accepted, this is the pioneering research to the knowledge of authors to establish the skill of a surgeon is essential to long-term outcomes among patients going through surgery for cancer treatment.
Bilimoria explained, it may "seem common sense in some ways, but we did not realize the magnitude of the effect." In previous research, the team did; there were 25-percent lesser term complications like colon leak or bleeding when a highly-skilled surgeon performed surgery for colon cancer.
Colon cancer is among the most common cancers, with more than 100,000 new cases diagnosed each year in the United States. In many circumstances, the operation is the primary therapy.
Bilimoria is the Surgical Outcomes and Quality Improvement Center of Northwestern director and a Robert H. Lurie Comprehensive Cancer Center of Northwestern University member.
A possible reason for the difference is that a skilled surgeon may be more likely to remove lymph nodes that have colon cancer. This was according to Dr. Brian Brajcich, the study first author and a Northwestern surgical resident and resident and research fellow.
Brajcich also said a less-skilled surgeon might not have the ability to remove as many lymph nodes, possibly "leaving cancer behind."
He added, patients who would benefit from undergoing chemotherapy following a surgery "won't receive it if we don't know that the cancer has spread to the lymph node."
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Finding Highly-Skilled Surgeon for Cancer
Because of this, many have become more interested in finding highly skilled cancer surgeons. To do so, Bilimoria said, ask how many similar procedures they have already performed.
The doctor also explained, a lot of experiences with the procedure is an ideal marker of skill. Furthermore, he said, general and colorectal surgeons, as well as surgical oncologists, all perform colon cancer surgery, and there can be excellent cancer surgeons in each of the fields mentioned.
In their research, the investigators specified that a surgeon's technical skill was scored according to a review of video footage of colon surgery by other surgeons, which included peers and expert reviewers.
The outcomes of patients whom the surgeons with higher- and lower skill-scores treated were then compared as well.
Improving outcomes following surgery, specifically surgery for cancer, needs to include initiatives targeting surgeons' technical skills.
More extensive strategies to help surgeons enhance their technical skills could comprise surgical training and the ability to evaluate and discuss video footage of surgery with peers, as well as experts in the field.
Bilimoria also said there is a need for further research to identify if initiatives to enhance surgical skills result in improved technical skills and patient results.
The study first author recognized the small size of the study. However, he explained, even if this is a little research, they see a huge impact.
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Oct 31, 2020 09:00 AM EDT
