High-volume centers--effect of case load on outcome in cancer surgery.

The detailed analysis of the literature of the past 10 years comprising 12 papers concerning pancreatic cancer and 10 dealing with esophageal cancer show a clear reduction of postoperative mortality with increasing case volume per year. Single papers have analyzed the main reasons for this phenomenon and showed that postoperative complication rates are lower in high-volume hospitals and their management of complications is more successful. Further long-term prognosis is also correlated to case volume. Surgery of pancreatic and esophageal cancer is a task for high-volume hospitals because they have less postoperative mortality and improved long-term prognosis compared to low-volume hospitals.