Quality in surgical oncology - Colon cancer

Quality in the treatment of colon cancer has many dimensions precluding measurement by one single parameter. Lymphadenectomy and hospital as well as individual case load are important determinants of surgical quality. Adequate lymphadenectomy improves survival in both stage II and III colon cancer. The effect of lymphadenectomy is greater than the effect of adjuvant therapy. Both the number of removed/examined nodes as well as the lymph node ratio are independent prognostic factors. A number of epidemiological studies have established a correlation between hospital case load and postoperative mortality. A few studies have also determined a correlation between hospital case load and prognosis. These correlations, although significant, are weak and the influence of individual case load on outcome is not fully understood yet.