Guidelines suggest that surgery for esophageal and gastric cancer should be conducted in large cancer centers.
Dr Thompson and colleagues from Scotland examined the relationship between hospital volume and outcome.
|5-year adjusted overall survival rate after surgical resection was 40%|
|British Journal of Surgery|
The team conducted a prospective, population-based study of 3293 consecutive patients with esophageal or gastric cancer diagnosed between 1997 and 1999.
The research team reported that 1302 patients underwent surgery, and were followed for 5 years after operation.
The 5-year adjusted overall survival rate for the 3293 patients was 19%.
The researchers found that the 5-year adjusted overall survival rate after surgical resection was 40%.
The research team noted that death within 1 year after surgical resection was associated with a postoperative complication.
Resection margin involvement by tumor after adjustment for age, sex and tumor location were associated with a postoperative complication.
There was no relationship between hospital volume, and postoperative morbidity or mortality.
The team observed no relationship between survival, and volume of patients either for hospital of diagnosis or hospital of surgery.
Dr Thompson's team concluded, “This population-based study of esophageal and gastric cancer suggests that the link between hospital volume and long-term survival for patients undergoing surgery requires re-evaluation.”