Association of institutional volume with surgical and oncologic outcomes for robotic rectal cancer surgery: a retrospective review.
High-volume hospitals have lower 90-day mortality after robotic rectal cancer surgery
Association of institutional volume with surgical and oncologic outcomes for robotic rectal cancer surgery: a retrospective review.
Robotic surgery has been increasingly adopted for rectal cancer.
This study aims to compare the perioperative and oncologic outcomes of robotic rectal cancer surgery at low-, medium-, and high-volume institutions.
Adults undergoing robotic proctectomy for primary rectal cancer were identified from the National Cancer Database (2010-2022).
high-volume centers had lower 90-day mortality
Among 327 institutions, thresholds for low, medium, and high were 1-4, 5-13, and > 13 cases/year.
The total number of patients and facilities for low, medium, and high were 10,945/142, 17,361/147, and 8,828/38, respectively.
High-volume institutions (high-volume institutions) operated more frequently on cN1-2 tumors (46.0, 50.0, 53.5%, p < 0.0005), but fewer poorly differentiated tumors (10.2, 9.8, 8.4%, p < 0.0003).
Differences in patient selection exist for robotic rectal cancer resection based on hospital volume.
high-volume institutions demonstrated better oncologic and perioperative outcomes, but there was no difference in long-term overall survival based on volume.
There is an opportunity for low- and medium-volume institutions to achieve appropriate long-term oncologic outcomes, but further work is needed to investigate patient selection and early post-operative mortality.