OBJECTIVE: Hospital mortality and long-term survival in major cancer surgery seems to be affected by hospital related factors. We evaluated the effect of university versus non-university hospital type, and surgical volume (0-4, 5-10, 11-20, and >20 average of cases/year) on the immediate and long-term survival of surgical non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS: Between 1988 and 2002, the number of NSCLC resections with curative intent in Finland was 5339. Follow-up until the end of 2003 from national registries was available on 91% (4878 of 5339) of patients. RESULTS: Multivariate analysis showed that hospital mortality was unaffected by hospital type or volume, but delay of >4 months from diagnosis to surgery did have an adverse effect. Surgery at university hospitals was associated with significantly better cancer-related and overall survival, as also was surgery at very low-volume but mainly private hospitals (0-4 cases/year). CONCLUSIONS: Undergoing surgery for non-small cell lung cancer at a university hospital may offer an advantage for long-term survival, but large hospital volume in itself did not. SUMMARY: Multivariate analysis on the effect of hospital type and surgical volume on immediate and long-term survival of 4878 lung cancer surgery patients, 1988-2002, showed that surgery at university hospitals was associated with significantly better cancer-related and overall survival, but hospital mortality did not differ. Large hospital volume did not independently predict a better outcome.
OBJECTIVE: Hospital mortality and long-term survival in major cancer surgery seems to be affected by hospital related factors. We evaluated the effect of university versus non-university hospital type, and surgical volume (0-4, 5-10, 11-20, and >20 average of cases/year) on the immediate and long-term survival of surgical non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS: Between 1988 and 2002, the number of NSCLC resections with curative intent in Finland was 5339. Follow-up until the end of 2003 from national registries was available on 91% (4878 of 5339) of patients. RESULTS: Multivariate analysis showed that hospital mortality was unaffected by hospital type or volume, but delay of >4 months from diagnosis to surgery did have an adverse effect. Surgery at university hospitals was associated with significantly better cancer-related and overall survival, as also was surgery at very low-volume but mainly private hospitals (0-4 cases/year). CONCLUSIONS: Undergoing surgery for non-small cell lung cancer at a university hospital may offer an advantage for long-term survival, but large hospital volume in itself did not. SUMMARY: Multivariate analysis on the effect of hospital type and surgical volume on immediate and long-term survival of 4878 lung cancer surgery patients, 1988-2002, showed that surgery at university hospitals was associated with significantly better cancer-related and overall survival, but hospital mortality did not differ. Large hospital volume did not independently predict a better outcome.
Authors: Paul J Scheel; Traves D Crabtree; Jennifer M Bell; Christine Frederiksen; Stephen R Broderick; A Sasha Krupnick; Daniel Kreisel; G Alexander Patterson; Bryan F Meyers; Varun Puri Journal: J Thorac Cardiovasc Surg Date: 2014-12-20 Impact factor: 5.209
Authors: Elizabeth A David; David T Cooke; Yingjia Chen; Andrew Perry; Robert J Canter; Rosemary Cress Journal: Am J Surg Date: 2015-06-27 Impact factor: 3.125