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Review
. 2024 Sep;26(9):1753-1757.
doi: 10.1111/codi.17119. Epub 2024 Aug 6.

Is centralization for rectal cancer surgery necessary?

Joseph Do Woong Choi  1   2 , Talia Shepherd  1 , Amy Cao  1 , Toufic El-Khoury  1   2   3 , Nimalan Pathma-Nathan  1   2 , James Wei Tatt Toh  1   2
Affiliations
Review

Is centralization for rectal cancer surgery necessary?

Joseph Do Woong Choi et al. Colorectal Dis. 2024 Sep.

Abstract

Rectal cancer surgery is complex and more technically challenging than colonic surgery. Over the last 30 years internationally, there has been a growing impetus for centralizing care to improve outcomes for rectal cancer. Centralizing care may potentially reduce variations of care, increase standardization and compliance with clinical practice guidelines. However, there are barriers to implementation at a professional, political, governance and resource allocation level. Centralization may increase inequalities to accessing healthcare, particularly impacting socioeconomically disadvantaged and rural populations with difficulties to commuting longer distances to "centres of excellence". Furthermore, it is unclear if centralization actually improves outcomes. Recent studies demonstrate that individual surgeon volume rather than hospital volume may be more important in achieving optimal outcomes. In this review, we examine the literature to assess the value of centralization for rectal cancer surgery.

Keywords: centralization; rectal cancer; survival; volume‐outcome.

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References

REFERENCES

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