Dataset Information

Hospital surgical volume and 3-year mortality in severe prognosis cancers: A population-based study using cancer registry data.

ABSTRACT:

Background

The impact of hospital surgical volume on long-term mortality has not been well assessed in Japan, especially for esophageal, biliary tract, and pancreatic cancer, although these three cancers need a high-level of medical technical skill. The purpose of this study was to examine associations between hospital surgical volume and 3-year mortality for these severe prognosis cancer patients.

Methods

Patients who received curative surgery for esophageal, biliary tract, and pancreatic cancers were analyzed using Osaka Cancer Registry data from 2006-2013. Hospital surgical volume was categorized into tertiles (high/middle/low) according to the average annual number of curative surgeries per hospital for each cancer. Three-year survivals were calculated using the Kaplan-Meier method. Hazard ratios (HRs) of 3-year mortality were calculated using Cox proportional hazard models, adjusting for patient characteristics.

Results

Three-year survival was higher with increased hospital surgical volume for all three cancers, but the relative importance of volume varied across sites. After adjustment for all confounding factors, HRs (95% Confidence interval [CI]) in middle- and low-volume hospitals were 1.34 (95% CI, 1.14-1.58) and 1.57 (95% CI, 1.33-1.86) for esophageal cancer; 1.39 (95% CI, 1.15-1.67) and 1.57 (95% CI, 1.30-1.89) for biliary tract cancer; 1.38 (95% CI, 1.16-1.63) and 1.90 (1.60-2.25) for pancreatic cancer, respectively. In particular localized pancreatic cancer, the impact of hospital surgical volume on 3-year mortality was strong (HRs: 2.66 [95% CI, 1.61-4.38]).

Conclusion

We suggest that patients who require curative surgery for esophageal, biliary tract, and pancreatic cancer may benefit from referral to high-volume hospitals.

SUBMITTER: Taniyama Y

PROVIDER: S-EPMC7738649 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Hospital Surgical Volume and 3-Year Mortality in Severe Prognosis Cancers: A Population-Based Study Using Cancer Registry Data.

Taniyama Yukari Y Tabuchi Takahiro T Ohno Yuko Y Morishima Toshitaka T Okawa Sumiyo S Koyama Shihoko S Miyashiro Isao I

Journal of epidemiology 20200111 1

<h4>Background</h4>The impact of hospital surgical volume on long-term mortality has not been well assessed in Japan, especially for esophageal, biliary tract, and pancreatic cancer, although these three cancers need a high level of medical-technical skill. The purpose of this study was to examine associations between hospital surgical volume and 3-year mortality for these severe-prognosis cancer patients.<h4>Methods</h4>Patients who received curative surgery for esophageal, biliary tract, and p ...[more]

PMID: 31932528

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