Introduction 

Complications of surgical oncology care have direct, immediate impacts on patient outcomes and downstream medical costs and capacity. Much of this data is collected within the Michigan Surgery Quality Collaborative (MSQC) – a statewide representative database which partners with hospitals to evaluate existing surgical protocols and implement QI efforts. Utilizing the MSQC, we analyze and provide a statistical landscape of the long-term trends across various cancer surgeries.

Methods

We performed a retrospective cohort study across 42 partner institutions between 2010-2022. Annual data from colectomy, proctectomy, pancreatectomy, and hepatectomy surgeries concerning non-UTI postoperative complications, length of hospital stay (LOS), and readmission rates were analyzed using linear regression.

Results

From 2011 to 2022, proctectomy had the greatest relative decline in complication rates (relative: -57%; absolute: -20%;  β = -1.3%; R²= 0.57), followed by colectomy (-50%; -15%; β = -1.1%; R²= 0.94) and pancreatectomy (-42%; -21%; β = -1.5%; R²= 0.70). From 2011 through 2019, hepatectomy complication rates declined (-46%; -18%; β = -0.9%; R²= 0.23). 

Proctectomy also had the greatest decline in LOS (-4.6 days; change: -50.9%; β = -0.32; R²= 0.80), followed by pancreatectomy (-3.5; -28.2%; β = -0.34; R²= 0.88) and colectomy (-1.8; -22.4%; β = -0.18; R²= 0.94). Hepatectomy LOS declined (-0.2; -2.5%; β = 0.04; R²= 0.02).

Colectomies had the largest decline in readmission rates (relative: 29%; absolute: 3%; β = -0.3%; R² = 0.71), followed by proctectomy (-2.9%; -0.5%; β = 0.3%; R²=0.18 ). Pancreatectomy readmission rates increased (76%; 9%; β = 0.4%; R²= 0.21). Hepatectomy rates declined (-38%; -5%; β = 0.2%; R²= 0.02).

Conclusions

Our results show colectomy, proctectomy, pancreatectomy, and hepatectomy surgical outcomes have improved. Our study was limited by retrospective analysis and generalizability outside Michigan. Future qualitative studies can elucidate best practices contributing to these positive trends and identify areas for quality improvement opportunities.