Surgeons' volume of colorectal cancer procedures and collaborative decision-making about adjuvant therapies

Selwyn O. Rogers, John Z. Ayanian, Clifford Y. Ko, Katherine L. Kahn, Alan M. Zaslavsky, Robert S. Sandler, Nancy L. Keating

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND: Few studies have assessed associations of surgeons' practice volume with processes of care that lead to better outcomes. OBJECTIVE: We surveyed surgeons treating colorectal cancer to determine whether high-volume surgeons were more likely to collaborate with other physicians in decisions about adjuvant therapies. SUBJECTS AND METHODS:: Surgeons caring for patients with colorectal cancer in multiple regions and health-care organizations were surveyed to assess their volume of colorectal cancer resections and participation in decisions about adjuvant chemotherapy and radiation therapy. We used logistic regression to assess physician and practice characteristics associated with surgical volume and the relation of surgical volume and these other characteristics to collaborative decision-making regarding adjuvant therapies. RESULTS:: Of 635 responding surgeons, those who identified themselves as surgical oncologists or colorectal surgeons were more likely than others to report high volume of colorectal cancer resections (P < 0.001), as were those who practiced at a comprehensive cancer center (P = 0.06) and attended tumor board meetings weekly (vs. quarterly or less, P = 0.09). Most surgeons reported a collaborative role in decisions about chemotherapy and radiation therapy. However, in adjusted analyses, higher-volume surgeons more often reported a collaborative role with other physicians in decisions about chemotherapy (P < 0.001) and radiation therapy (P < 0.001). CONCLUSIONS:: Higher-volume surgeons are more likely to report collaborating with other physicians in decisions about adjuvant therapies for patients following colorectal cancer surgery. This collaborative decision-making of higher-volume surgeons may contribute to outcome differences by surgeon volume.

Original languageEnglish (US)
Pages (from-to)895-900
Number of pages6
JournalAnnals of Surgery
Volume250
Issue number6
DOIs
StatePublished - Dec 2009
Externally publishedYes

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Colorectal Neoplasms
Decision Making
Therapeutics
Physicians
Radiotherapy
Surgeons
Drug Therapy
Colorectal Surgery
Adjuvant Chemotherapy
Neoplasms
Logistic Models
Delivery of Health Care

ASJC Scopus subject areas

  • Surgery

Cite this

Rogers, S. O., Ayanian, J. Z., Ko, C. Y., Kahn, K. L., Zaslavsky, A. M., Sandler, R. S., & Keating, N. L. (2009). Surgeons' volume of colorectal cancer procedures and collaborative decision-making about adjuvant therapies. Annals of Surgery, 250(6), 895-900. https://doi.org/10.1097/SLA.0b013e3181afe0c6

Surgeons' volume of colorectal cancer procedures and collaborative decision-making about adjuvant therapies. / Rogers, Selwyn O.; Ayanian, John Z.; Ko, Clifford Y.; Kahn, Katherine L.; Zaslavsky, Alan M.; Sandler, Robert S.; Keating, Nancy L.

In: Annals of Surgery, Vol. 250, No. 6, 12.2009, p. 895-900.

Research output: Contribution to journalArticle

Rogers, SO, Ayanian, JZ, Ko, CY, Kahn, KL, Zaslavsky, AM, Sandler, RS & Keating, NL 2009, 'Surgeons' volume of colorectal cancer procedures and collaborative decision-making about adjuvant therapies', Annals of Surgery, vol. 250, no. 6, pp. 895-900. https://doi.org/10.1097/SLA.0b013e3181afe0c6
Rogers, Selwyn O. ; Ayanian, John Z. ; Ko, Clifford Y. ; Kahn, Katherine L. ; Zaslavsky, Alan M. ; Sandler, Robert S. ; Keating, Nancy L. / Surgeons' volume of colorectal cancer procedures and collaborative decision-making about adjuvant therapies. In: Annals of Surgery. 2009 ; Vol. 250, No. 6. pp. 895-900.
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