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Yeo H , Niland J , Milne D , ter Veer A , Bekaii-Saab T , Farma JM , Lai L , Skibber JM , Small W Jr , Wilkinson N , Schrag D , Weiser MR
Incidence of minimally invasive colorectal cancer surgery at national comprehensive cancer network centers
J Natl Cancer Inst. 2015 Jan;107(1) :362
PMID: 25527640    PMCID: PMC4296195   
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Abstract
BACKGROUND: Laparoscopic colectomy has been shown to have equivalent oncologic outcomes to open colectomy for the management of colon cancer, but its adoption nationally has been slow. This study investigates the prevalence and factors associated with laparoscopic colorectal resection at National Comprehensive Cancer Network (NCCN) centers. METHODS: Data on patients undergoing surgery for colon and rectal cancer at NCCN centers from 2005 to 2010 were obtained from chart review of medical records for the NCCN Outcomes Project and included information on socioeconomic status, insurance coverage, comorbidity, and physician-reported Eastern Cooperative Oncology Group (ECOG) performance status. Associations between receipt of minimally invasive surgery and patient and clinical variables were analyzed with univariate and multivariable logistic regression. All statistical tests were two-sided. RESULTS: A total of 4032 patients, diagnosed between September 2005 and December 2010, underwent elective colon or rectal resection for cancer at NCCN centers. Median age of colon cancer patients was 62.6 years, and 49% were men. The percent of colon cancer patients treated with minimally invasive surgery (MIS) increased from 35% in 2006 to 51% in 2010 across all centers but varied statistically significantly between centers. On multivariable analysis, factors associated with minimally invasive surgery for colon cancer patients who had surgery at an NCCN institution were older age (P = .02), male sex (P = .006), fewer comorbidities (P </= .001), lower final T-stage (P < .001), median household income greater than or equal to $80000 (P < .001), ECOG performance status = 0 (P = .02), and NCCN institution (P </= .001). CONCLUSIONS: The use of MIS increased at NCCN centers. However, there was statistically significant variation in adoption of MIS technique among centers.
Notes
1460-2105 Yeo, Heather Niland, Joyce Milne, Dana ter Veer, Anna Bekaii-Saab, Tanios Farma, Jeffrey M Lai, Lily Skibber, John M Small, William Jr Wilkinson, Neal Schrag, Deborah Weiser, Martin R P30 CA008748/CA/NCI NIH HHS/United States Journal Article Research Support, N.I.H., Extramural United States J Natl Cancer Inst. 2014 Dec 19;107(1):362. doi: 10.1093/jnci/dju362. Print 2015 Jan.