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Hospital volume associated with mortality from esophageal and gastric cancer

The latest issue of Gut evaluates hospital volume, proportion resected and mortality from esophageal and gastric cancer.

News image

Dr Victoria Coupland and colleagues from the United Kingdom assessed the associations between hospital volume, resection rate and survival of esophageal and gastric cancer patients in England.

The team identified 62,811 patients diagnosed with esophageal or gastric cancer between 2004 and 2008 from a national population-based cancer registration and Hospital Episode Statistics-linked dataset.

The research team used cox regression analyses to assess all-cause mortality according to hospital volume and resection rate, adjusting for case-mix variables.

The team evaluated 3 predefined periods following surgery, including 30, 30–365, and 365 days.

The researchers found that the analysis of mortality in relation to resection rate was performed among all patients, and among the 13,189 resected patients.

Increasing hospital volume was associated with lower mortality.

Increasing hospital volume was associated with lower mortality
Gut

The doctors noted that in relative terms, the association between increasing hospital volume and lower mortality was particularly strong in the first 30 days following surgery, but a clinically relevant association remained beyond 1 year.

Increasing resection rates were associated with lower mortality among all patients.

Dr Coupland's team concluded, "With evidence of lower short-term and longer-term mortality for patients resected in high-volume hospitals, this study supports further centralization of esophageal and gastric cancer surgical services in England."

Gut 2013;62:961-966
25 June 2013

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