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Updated: Jan 30, 2026
08:44
The Utility of Stage-specific Mid-to-late Drosophila Follicle Isolation
Published on: December 2, 2013
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Surgeon-Level Variation in Utilization of Local Staging and Neoadjuvant Therapy for Stage II-III Rectal
Douglas S Swords1,2, David E Skarda3,4, William T Sause5
1Surgical Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA. douglas.swords@hsc.utah.edu.
Summary
Omission of neoadjuvant therapy (NT) for rectal cancer often stems from missed local staging. Improving local staging rates is key to increasing NT utilization and improving patient outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Neoadjuvant therapy (NT) is standard for stage II-III rectal adenocarcinoma but underutilized.
- Reasons for NT omission, particularly local staging, require investigation.
Purpose of the Study:
- To identify factors contributing to the omission of local staging and NT in rectal cancer.
- To assess the impact of surgeon volume and tumor location on treatment decisions.
Main Methods:
- Retrospective study of 240 patients with stage II-III rectal adenocarcinoma (2010-2016).
- Multivariable analysis to determine risk factors for omission.
- Surgeon-specific rates calculated and correlated with outcomes.
Main Results:
- Local staging omitted in 17.9%, NT in 17.1%.
- Upper rectal tumors and low surgeon volume were linked to omissions.
- NT omission strongly correlated with prior local staging omission (87.8%).
- NT associated with reduced positive margins, node positivity, and local recurrence.
Conclusions:
- NT omission is frequently a consequence of failing to perform local staging.
- Quality improvement initiatives should prioritize enhancing local staging rates for rectal cancer.
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