Tertiary Care Multidisciplinary Teams Associated with Improved Survival in Rectal Cancer Patients: A Comparative Study

Abstract

For stage II/III rectal cancer patients, comprehensive multidisciplinary care (MDC) affects outcomes. Randomized trials have shown the effectiveness of adjuvant and neoadjuvant therapy in treatment of these patients. However, the effectiveness of collaboration within MDC is undetermined. It is possible that regional variation in survival outcomes may be tied to treatment facility. We retrospectively reviewed a prospectively collected database of patients with stage II/III rectal cancer who received MDC at any location and underwent oncologic colorectal resection at a tertiary care center (TCC) between 2005 and 2011. Of the 571 rectal cancer patients, 391 had a stage II/III rectal cancer and received surgery at a TCC. After exclusion criteria, we observed that 120 patients received neoadjuvant therapy and 119 patients received adjuvant therapy. For neoadjuvant patients, no difference in overall survival was observed between treatment received at a TCC versus an outside facility. However, a significant improvement in survival was observed in patients who received adjuvant therapy at a TCC (P = 0.01). Thus, the location of postoperative adjuvant therapy shows improvement in 10-year survival at a TCC versus elsewhere. Thus, standardization of care can impact outcomes for invasive rectal cancer patients. The limitations of this study are its retrospective nature and relatively small sample size.