Hospital volume: operative morbidity, mortality and survival in thoracotomy for lung cancer.A Spanish multicenter study of 2994 cases

Freixinet, J.; Juliá-Serdà, Gabriel; Rodríguez, Pedro; Santana, N.; Castro, Felipè Rodríguez de; Fiuza, María D.; López-Encuentra, Ángel

doi:10.1016/j.ejcts.2005.10.014

Cited by 37 publications

(24 citation statements)

References 19 publications

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“…In Norway, as in other countries, lung cancer surgery is being centralised to high-volume hospitals despite the fact that the impact of hospital volume is still debated 25 26. This study could not corroborate a significant effect of hospital volume on postoperative mortality, although the OR at high-volume hospitals was more favourable.…”

Section: Discussioncontrasting

confidence: 65%

Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude

Strand

Rostad

Damhuis³

et al. 2007

Thorax

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Background: There is considerable variability in reported postoperative mortality and risk factors for mortality after surgery for lung cancer. Population-based data provide unbiased estimates and may aid in treatment selection. Methods: All patients diagnosed with lung cancer in Norway from 1993 to the end of 2005 were reported to the Cancer Registry of Norway (n = 26 665). A total of 4395 patients underwent surgical resection and were included in the analysis. Data on demographics, tumour characteristics and treatment were registered. A subset of 1844 patients was scored according to the Charlson co-morbidity index. Potential factors influencing 30-day mortality were analysed by logistic regression. Results: The overall postoperative mortality rate was 4.4% within 30 days with a declining trend in the period. Male sex (OR 1.76), older age (OR 3.38 for age band 70-79 years), right-sided tumours (OR 1.73) and extensive procedures (OR 4.54 for pneumonectomy) were identified as risk factors for postoperative mortality in multivariate analysis. Postoperative mortality at high-volume hospitals (>20 procedures/year) was lower (OR 0.76, p = 0.076). Adjusted ORs for postoperative mortality at individual hospitals ranged from 0.32 to 2.28. The Charlson co-morbidity index was identified as an independent risk factor for postoperative mortality (p = 0.017). A prediction model for postoperative mortality is presented. Conclusions: Even though improvements in postoperative mortality have been observed in recent years, these findings indicate a further potential to optimise the surgical treatment of lung cancer. Hospital treatment results varied but a significant volume effect was not observed. Prognostic models may identify patients requiring intensive postoperative care.

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Section: Discussioncontrasting

confidence: 65%

Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude

Strand

Rostad

Damhuis³

et al. 2007

Thorax

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“…The surgical volume Several authors [331][332][333][334], although not all [335][336][337][338], have found an inverse relationship between surgical volume and post-operative morbidity and mortality rates, and even longterm survival of lung cancer patients.…”

Section: Quality Of Lung Cancer Surgerymentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

Eur Respir J

772

550

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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“…Numerous studies dealing with the relationship of hospital volume to operative mortality after resection of lung cancer have been published, [6][7][8][9][10][11][12][13][14] In 1992, Romano and Mark 6 reported the outcome of 12,439 adults who underwent pulmonary resection through California hospital discharge abstracts between 1983 and 1986. Mortality was 4.2% after lobectomy and 11.6% after pneumonectomy.…”

Section: Discussionmentioning

confidence: 99%

Ninety-day mortality after resection for lung cancer is nearly double 30-day mortality

Pezzi

Mallin

Samayoa

et al. 2014

The Journal of Thoracic and Cardiovascular Surgery

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Hospital volume: operative morbidity, mortality and survival in thoracotomy for lung cancer.A Spanish multicenter study of 2994 cases

Abstract: No significant differences that do not favor the hypothesis that there is increased surgical risk and worse survival in centers having a lower volume were found in this Spanish multicenter study.

Cited by 37 publications

References 19 publications

Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude

Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Ninety-day mortality after resection for lung cancer is nearly double 30-day mortality

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