High Procedure Volume Is Strongly Associated With Improved Survival After Lung Cancer Surgery

Lüchtenborg, Margreet; Riaz, Sharma P.; Coupland, Victoria H.; Lim, Eric; Jakobsen, Erik; Krasnik, Mark; Page, Richard; Lind, Michael; Peake, Michael; Møller, Henrik

doi:10.1200/jco.2013.49.0219

Cited by 176 publications

(159 citation statements)

References 28 publications

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“…The analyses of 30-day and 90-day mortality risks in relation to hospital volume are consistent with previous analyses of hazard ratios for death, obtained from Cox proportional hazards regression (11). The analyses of mortality outcomes in lung cancer patients in England in relation to surgical procedure volume adds to growing body of evidence of favourable outcomes in high-volume hospital settings (11,(13)(14)(15)(16).…”

Section: Comparison With Other Studiessupporting

confidence: 82%

“…The principles of data extraction and linkages were as described previously (9,11). The dataset for the analysis was based on national cancer registration and hospital discharge …”

Section: Study Population and Main Predictor Variablesmentioning

confidence: 99%

“…The analyses of mortality outcomes in lung cancer patients in England in relation to surgical procedure volume adds to growing body of evidence of favourable outcomes in high-volume hospital settings (11,(13)(14)(15)(16). It is noteworthy that the 30-day mortality outcome is insufficient to capture the full mortality effect, and that 90-day mortality is more than three times the magnitude of 30-day mortality (2.8% vs. 0.9%).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…This emphasises that mortality outcomes should be considered both in the short and the longer term (11).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…There is evidence that patient survival is better when surgical care is provided by a multi-disciplinary team in hospitals with high-volume practices, and analysis of surgical data from England in patients diagnosed in 2004-2008 showed lower death rates in patients operated in large-volume hospitals (11). It remains to be addressed whether treating patients in high-volume surgical centres can lead to improvement in other relevant outcomes, such as shorter length of hospital stay, decreased frequency and severity of postoperative complications, decreased re-admission to hospital, and improved patient experience and satisfaction.…”

Section: Introductionmentioning

confidence: 99%

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High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Møller

Riaz

Holmberg

et al. 2016

European Journal of Cancer

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High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of readmission and death: national cohort analysis in England.Henrik Møller (1, 2, 3, 4), Shama Sheikh (2), Lars Holmberg (1), Erik Jakobsen (5), Jesper Lagergren (1), Richard Page (6), Michael D. Peake (3), Neil Pearce (7), Arnie Purushotham Hospitals with large lung cancer surgical resection volumes were less conservative in their selection of patients for surgical management, and provided a higher resection rate to their geographical population. The large hospitals had shorter length of stay and the odds of readmission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 days and 3% after 90 days. Patients from hospitals in the highest volume quintile had about half the odds of death within 30 days than patients from the lowest quintile.Variations in outcomes were all in the same direction, with consistent better outcomes in the larger hospitals. This gives support to the ongoing trend towards centralisation of clinical services, but service re-organisation needs to take account of not only the size of hospitals but also referral routes and patient access.

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Section: Comparison With Other Studiessupporting

confidence: 82%

“…The principles of data extraction and linkages were as described previously (9,11). The dataset for the analysis was based on national cancer registration and hospital discharge …”

Section: Study Population and Main Predictor Variablesmentioning

confidence: 99%

Section: Comparison With Other Studiesmentioning

confidence: 99%

“…This emphasises that mortality outcomes should be considered both in the short and the longer term (11).…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Møller

Riaz

Holmberg

et al. 2016

European Journal of Cancer

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Analysis of Radiation Facility Volume and Survival in Men With Lymph Node–Positive Prostate Cancer Treated With Radiation and Androgen Deprivation Therapy

et al. 2020

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IMPORTANCE Long-term control of node-positive (N1) prostate cancer, the incidence of which is increasing, is obtainable with aggressive treatment, and definitive external beam radiation therapy (EBRT) with long-term androgen deprivation therapy (ADT) is an increasingly preferred option.Caring for these patients is complex and may require resources more readily available at highvolume centers. OBJECTIVETo evaluate the association between radiation facility case volume and overall survival (OS) in men with N1 prostate cancer. DESIGN, SETTING, AND PARTICIPANTSThis cohort study included 1899 men diagnosed with T1N1M0 to T4N1M0 prostate cancer treated with curative-intent EBRT and ADT between January 2004 and December 2016 at US facilities reporting to the National Cancer Database. Data analysis was performed from March to June 2020. EXPOSURES Treatment at a center with high vs low average cumulative facility volume (ACFV), defined as the total number of prostate radiation cases at an individual patient's treatment facility from 2004 until the year of that patient's diagnosis. MAIN OUTCOMES AND MEASURES OS was assessed between high-vs low-ACFV centers using theKaplan-Meier method with and without propensity score-based weighted adjustment and multivariable Cox proportional hazards. The nonlinear association between continuous ACFV and OS was examined through a Martingale residual plot, and the optimal ACFV cutoff point that maximized the separation between high vs low ACFV was identified via a bias adjusted log rank test. RESULTSA total of 1899 men met inclusion criteria. The median (interquartile range) age was 66 (60-72) years, 1491 (78.5%) were White individuals, and 1145 (60.3%) were treated at nonacademic centers. The optimal ACFV cutoff point was 66.4 patients treated per year. The median OS for patients treated at high-ACFV vs low-ACFV centers was 111.1 (95% CI, 101.5-127.9) months and 92.3 (95% CI, 87.7-103.9) months, respectively (P = .01). On multivariable analysis, treatment at a low-ACFV center was associated with increased risk of death (HR, 1.22; 95% CI, 1.02-1.46, P = .03) compared with treatment at a high-ACFV center. These results persisted after propensity scorebased adjustment. CONCLUSIONS AND RELEVANCEThis cohort study found a significant association of facility case volume with long-term outcomes in men with N1 prostate cancer undergoing EBRT with ADT.Specifically, treatment at a facility with high radiation case volume was independently associated (continued) Key Points Question Is a cancer facility's radiation case volume associated with long-term outcomes in men with advanced prostate cancer who were treated with primary radiation therapy? Findings In this cohort study of 1899 men from a large US cancer database, men with node-positive prostate cancer undergoing curative-intent radiation therapy with concurrent androgen deprivation therapy had significantly improved median survival rates if they were treated at facilities with a high volume of such patients, independent of academic affiliation....

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Comparison of Outcomes and Process of Care for Patients Treated at Hospitals Dedicated for COVID-19 Care vs Other Hospitals

et al. 2022

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IMPORTANCEEarly in the SARS-CoV-2 pandemic, the M Health Fairview Hospital System established dedicated hospitals for establishing cohorts and caring for patients with COVID-19, yet the association between treatment at COVID-19-dedicated hospitals and mortality and complications is not known. OBJECTIVE To analyze the mortality rate and complications associated with treatment at the COVID-19-dedicated hospitals.

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High Procedure Volume Is Strongly Associated With Improved Survival After Lung Cancer Surgery

Abstract: High-volume hospitals have higher resection rates and perform surgery among patients who are older, have lower socioeconomic status, and have more comorbidities; despite this, they achieve better survival, most notably in the early postoperative period.

Cited by 176 publications

References 28 publications

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

High lung cancer surgical procedure volume is associated with shorter length of stay and lower risks of re-admission and death: National cohort analysis in England

Analysis of Radiation Facility Volume and Survival in Men With Lymph Node–Positive Prostate Cancer Treated With Radiation and Androgen Deprivation Therapy

Comparison of Outcomes and Process of Care for Patients Treated at Hospitals Dedicated for COVID-19 Care vs Other Hospitals

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