Rainer Kube and his working group report in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2011; 108: 41-6) on new treatment strategies in patients with colon cancer.
The findings of multicenter observational studies are a good basis for improvements to overall quality of patient care. Against this background, from 2000 to 2004 Kube and his coauthors collected data on over 31 000 patients in 346 German hospitals. From this data pool they extracted statements about the quality of care. They discovered, for example, that colonoscopy screening has led to only a marginal reduction in the percentage of tumors at an advanced stage of disease. In addition, patients in whom the surgeon had to convert intraoperatively from an endoscopic (keyhole) to an open procedure had a poorer oncological result. The authors’ analysis produced new indicators of possible complication risks. For example, leakage from bowel sutures resulted in a markedly poorer long-term disease course for the patient. The authors emphasize that their study could contribute to optimization of surgical technique during operations.