Increased Caseload Volume is Associated With Better Oncologic Outcomes After Laparoscopic Resections for Colorectal Cancer

Purpose: To evaluate the impact of caseload volume on the outcomes of open and laparoscopic surgery for colorectal cancer. Methods: Between April 1999 and January 2011, patients who underwent open or laparoscopic resection for colorectal adenocarcinoma with curative intent were identified. There were 2 groups of surgeons, whose primary practice is gastrointestinal surgery (n = 5, group A) and general surgery (n = 14, group B). Histopathologic and oncologic outcomes, as well as survival data were evaluated. Results: A total of 815 patients fulfilled the study criteria and 356 (group A: 120, group B: 236) patients who had > 2 years' follow-up data were included. Colorectal procedures constituted 33% and 19% of all the operations in A and B groups, respectively (P < 0.0001). Among the colorectal cases, rates of laparoscopic surgery were 37% and 20% in the group A and B, respectively (P < 0.0001). Practice pattern was independently associated with better overall survival and was favoring the group A (P = 0.02). Conclusions: Increased caseload volume improves oncologic outcomes in patients undergoing colorectal resection for nonmetastatic cancer.