Related Experiment Video
Updated: Jun 19, 2026
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Centralization of rectal cancer surgery improves long-term survival
1Colorectal Unit, Department of Surgery and Centre for Clinical Research of Uppsala University, Central Hospital, Västerås, Sweden. maziar.hosseinalikhani@ltv.se
Aim:
In 1996, rectal cancer surgery in the Swedish county of Vstmanland was centralized to a single colorectal unit. At the same time, total mesorectal excision and multidisciplinary team meetings were introduced. The aim of this audit was to determine the long-term results before and after centralization.
Method:
All consecutive rectal cancer patients who underwent curative or palliative surgery at one of the county's four hospitals between 1993 and 1996 (n = 133, group 1) were compared with patients operated at the new centralized colorectal unit between 1996 and 1999 (n = 144, group 2).
Results:
Preoperative radiotherapy was common in both groups, but in group 2, it was planned using MRI. Local recurrences were detected in 8% of all patients operated in group 1 vs 3.5% in group 2 (P = 0.043). The overall 5-year survival for all patients in group 1 was 38 vs 62% in group 2 (P = 0.003). According to multivariate analysis, the new colorectal unit was an independent predictor for improved long-term survival.
Conclusion:
This population-based audit shows reduced local recurrence rate and prolonged overall survival for rectal cancer patients after centralization to a single colorectal unit with multidisciplinary management and increased subspecialization.
