Clinical Corner - March 2022

March is “Colorectal Cancer Awareness Month” so it is appropriate to include some clinical facet of this malignancy in this month’s “Clinical Corner.” All of us will see many scientific reports and articles in the lay press this month that highlight the importance of colorectal malignancy. It is imperative to remember and promote the truism that all data included in these reports emanate from the cancer registry and reflect your work and dedication!

One such study, recently published in the Journal of the American College of Surgeons (2/7/2022), reports the work of the Michigan Surgical Quality Collaborative and focuses on complication rates after colectomy. The authors’ goal was to estimate whether complications were related to patient co-morbidities, surgeon performance, or hospital system factors.

A total of 15,755 patients were included in the study. The mean hospital-level complication rate was 15.8% (range, 8.7% to 30.2%). The proportion of complications attributable to patient factors was 35.0%, while 2.4% was attributable to the surgeon and 1.8% was attributable to hospital systemic issues. This study demonstrated that factors at the patient level (co-morbidities) contributed 8-fold more to the development of complications after colectomy compared with variance at the surgeon and hospital level. This study underscores the importance for our cancer registries to collect data relating to co-morbidities of our cancer patients. This is a challenge that we all need to embrace.