Specialist-Delivered Colonic Cancer Surgery in the Irish Model 3 Hospital: A Single-Centre Experience

Area of Science:

• Surgical Oncology
• Colorectal Surgery
• Health Services Research

Background:

• Centralizing colorectal cancer surgery (CCS) may overburden specialized centers and limit local patient access.
• Regional hospitals can potentially provide high-quality CCS.
• Fellowship-trained colorectal surgeons are key to delivering specialized care regionally.

Purpose of the Study:

• To evaluate the outcomes of CCS performed in a regional hospital setting.
• To compare regional CCS outcomes against national key performance indicators and textbook standards.
• To assess the feasibility and safety of localized colorectal cancer treatment.

Main Methods:

• Retrospective analysis of 50 consecutive CCS patients at a regional hospital.
• Collection of demographic, perioperative, postoperative, and oncological data.
• Comparison of outcomes with established colorectal cancer benchmarks.

Main Results:

• High R0 resection rate (98%) and median lymph node yield (20) achieved.
• Low 30-day morbidity (14%), readmission (0%), and mortality (0%).
• Survival rates at 5 years: Overall (77%), Disease-Free (75%).

Conclusions:

• Colorectal cancer surgery can be safely and effectively delivered in regional hospitals by subspecialists.
• Local delivery of high-quality oncological surgery benefits patients and reduces tertiary center burden.
• Optimizing resource utilization is crucial given the projected increase in colorectal cancer cases.