Authors
Haruku Fujita, Ryosuke Okamura, Koya Hida, Daisuke Nishizaki, Yoshihisa Umemoto, Yoshiro Itatani, Seiichiro Yamamoto, Tomonori Akagi, Kazutaka Obama, Takeshi Naitoh
Published in
Surgery today. Aug 06, 2026. Epub Aug 06, 2026.
Abstract
This study assessed whether institutional case volume influences the short- and long-term outcomes following laparoscopic surgery for LARC in a nationwide Japanese cohort.
Patients who underwent laparoscopic surgery for clinical stage II/III rectal cancer between 2010 and 2011 at 55 centers were analyzed. Hospitals were categorized as higher-volume (HVHs) or lower-volume (LVHs). Mixed-effects models adjusted for 13 clinical and demographic variables estimated the adjusted odds ratios (aORs) for postoperative complications and adjusted hazard ratios (aHRs) for the 5-year relapse-free survival (RFS) and overall survival (OS).
Among the 571 patients, 271 underwent surgery at nine HVHs and 300 at 46 LVHs. HVHs had significantly fewer postoperative complications (23.6% vs. 35.3%; aOR 0.52, 95% confidence interval [CI] 0.32-0.85, p = 0.009), shorter operation times (p = 0.013), and lower blood loss (p = 0.018). The 5-year RFS and OS rates were comparable between the groups (RFS: 65.3% and 63.5%; and OS: 80.6% and 81.0%), with no significant differences after adjustment (RFS: aHR 1.02, 95% CI 0.75-1.39, p = 0.909; OS: aHR 1.15, 95% CI 0.74-1.79, p = 0.529).
A higher hospital volume was associated with better short-term outcomes of laparoscopic surgery for LARC, whereas no significant association was observed between hospital volume and long-term oncological outcomes.
This study was registered in the UMIN Clinical Trials Registry System (UMIN000013919).
PMID:
42560538
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.
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