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National variation in pulmonary metastasectomy for colorectal cancer

Fenton, HM; Finan, PJ; Milton, R; Shackcloth, M; Taylor, JC; Treasure, T; Morris, EJA; (2021) National variation in pulmonary metastasectomy for colorectal cancer. Colorectal Disease 10.1111/codi.15506. (In press). Green open access

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Abstract

AIM: Evidence on patterns of use of pulmonary metastasectomy in colorectal cancer patients is limited. This population‐based study aims to investigate the use of pulmonary metastasectomy in the colorectal cancer population across the English National Health Service (NHS) and quantify the extent of any variations in practice and outcome. METHODS: All adults who underwent a major resection for colorectal cancer in an NHS hospital between 2005 and 2013 were identified in the COloRECTal cancer data Repository (CORECT‐R). All inpatient episodes corresponding to pulmonary metastasectomy, occurring within 3 years of the initial colorectal resection, were identified. Multi‐level logistic regression was used to determine patient and organizational factors associated with the use of pulmonary metastasectomy for colorectal cancer, and Kaplan–Meier and Cox models were used to assess survival following pulmonary metastasectomy. RESULTS: In all, 173 354 individuals had a major colorectal resection over the study period, with 3434 (2.0%) undergoing pulmonary resection within 3 years. The frequency of pulmonary metastasectomy increased from 1.2% of patients undergoing major colorectal resection in 2005 to 2.3% in 2013. Significant variation was observed across hospital providers in the risk‐adjusted rates of pulmonary metastasectomy (0.0%–6.8% of patients). Overall 5‐year survival following pulmonary resection was 50.8%, with 30‐day and 90‐day mortality of 0.6% and 1.2% respectively. CONCLUSIONS: This study shows significant variation in the rates of pulmonary metastasectomy for colorectal cancer across the English NHS.

Type: Article
Title: National variation in pulmonary metastasectomy for colorectal cancer
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/codi.15506
Publisher version: https://doi.org/10.1111/codi.15506
Language: English
Additional information: © 2021 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).
Keywords: colorectal cancer, pulmonary metastasectomy, pulmonary metastases
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics > Clinical Operational Research Unit
URI: https://discovery.ucl.ac.uk/id/eprint/10125598
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