The enormous influence of the surgeon on outlook in cancer was stressed by Professor Cornelis van de Velde of the Department of Surgery, Leiden University Medical Center, the Netherlands, during the 1997 European Cancer Conference.
Quality of surgery can make the most tremendous difference to your chances of survival and the quality of a patients remaining life, said Professor van de Velde. In rectal cancer, for example, the local recurrence rate can vary enormously between surgeons, from 5% to 50% or 60%, and this can affect not only your risk of dying of metastases, but the degree of suffering. Many local recurrences in rectal cancer are untreatable and cause immense and unbearable symptoms.
Survival rates in gastric and rectal cancer can vary as much as 5% to 10% between different surgeons, more than the effect gained from adjuvant treatment. Professor van de Velde continued. Morbidity, mortality and survival vary substantially between surgeons. Also more extensive surgery does not necessarily improve survival, so addressing the issues about individual surgical performance is a major issue.