Russell et al1 have added more information to the debate over the treatment of rectal cancer in institutions focused on the treatment of rectal cancer. Although the treatment of patients with rectal cancer in higher-volume academic centers with neoadjuvant protocols does not guarantee good surgical outcomes, it seems to help. Because no type of hospital (even a high-volume academic hospital) was immune to high outlier status for circumferential margins positive for cancer, the need for quality assurance and improvement in processes is extremely important for any hospital/institution that treats patients with rectal cancer.
Fleshman JW. Multidisciplinary Treatment of Rectal CancerThe Way of the Future. JAMA Surg. 2013;148(8):778. doi:10.1001/jamasurg.2013.2151