Koji Matsuo1,2, Shinya Matsuzaki1, Rachel S Mandelbaum1, Kazuhide Matsushima3, Maximilian Klar4, Brendan H Grubbs5, Lynda D Roman1,2, Jason D Wright6. 1. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California. 2. Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California. 3. Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, California. 4. Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany. 5. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, California. 6. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York.
Abstract
BACKGROUND AND OBJECTIVES: To examine the association between hospital surgical volume and perioperative mortality of pelvic exenteration performed for gynecologic malignancies. METHODS: A population-based retrospective study utilizing the Nationwide Inpatient Sample was conducted to examine pelvic exenteration for gynecologic malignancies from 2001 to 2011. Annualized hospital surgical volume was defined as the average number of procedures a hospital performed per year in which at least one case was performed, and this was correlated to perioperative mortality. RESULTS: A total 1912 exenterations performed at 181 centers were included. Nearly two thirds of exenteration-performing centers had a minimum surgical volume of one case per year (121 centers, 66.9%). Perioperative mortality rate was 1.8%. In multivariable analysis surgical volume remained an independent factor for perioperative mortality (adjusted-odds ratio 0.21; 95% confidence interval, 0.09-0.49; P < .001). Perioperative mortality rates were 3.7% for the centers with minimum surgical volume (1 exenteration a year), 1.4% for the centers performing more than one but two or less exenterations a year, and 0% for the top decile centers (>2 exenterations a year), respectively (P < .001). CONCLUSION: Pelvic exenteration for gynecologic malignancy is a rare surgical procedure with most hospitals performing few cases annually. A higher surgical volume of pelvic exenteration was associated with lower perioperative mortality.
BACKGROUND AND OBJECTIVES: To examine the association between hospital surgical volume and perioperative mortality of pelvic exenteration performed for gynecologic malignancies. METHODS: A population-based retrospective study utilizing the Nationwide Inpatient Sample was conducted to examine pelvic exenteration for gynecologic malignancies from 2001 to 2011. Annualized hospital surgical volume was defined as the average number of procedures a hospital performed per year in which at least one case was performed, and this was correlated to perioperative mortality. RESULTS: A total 1912 exenterations performed at 181 centers were included. Nearly two thirds of exenteration-performing centers had a minimum surgical volume of one case per year (121 centers, 66.9%). Perioperative mortality rate was 1.8%. In multivariable analysis surgical volume remained an independent factor for perioperative mortality (adjusted-odds ratio 0.21; 95% confidence interval, 0.09-0.49; P < .001). Perioperative mortality rates were 3.7% for the centers with minimum surgical volume (1 exenteration a year), 1.4% for the centers performing more than one but two or less exenterations a year, and 0% for the top decile centers (>2 exenterations a year), respectively (P < .001). CONCLUSION: Pelvic exenteration for gynecologic malignancy is a rare surgical procedure with most hospitals performing few cases annually. A higher surgical volume of pelvic exenteration was associated with lower perioperative mortality.
Authors: Jason D Wright; Maria P Ruiz; Ling Chen; Lisa R Gabor; Ana I Tergas; Caryn M St Clair; June Y Hou; Cande V Ananth; Alfred I Neugut; Dawn L Hershman Journal: Obstet Gynecol Date: 2018-07 Impact factor: 7.661
Authors: Arman Kilic; Thomas G Gleason; Hiroshi Kagawa; Ahmet Kilic; Ibrahim Sultan Journal: Eur J Cardiothorac Surg Date: 2019-02-02 Impact factor: 4.191
Authors: Deborah Schrag; Katherine S Panageas; Elyn Riedel; Laura D Cramer; Jose G Guillem; Peter B Bach; Colin B Begg Journal: Ann Surg Date: 2002-11 Impact factor: 12.969
Authors: L Tortorella; J Casarin; K C Mara; A L Weaver; F Multinu; G E Glaser; W A Cliby; G Scambia; A Mariani; A Kumar Journal: Gynecol Oncol Date: 2018-11-08 Impact factor: 5.482
Authors: Randa J Jalloul; Alpa M Nick; Mark F Munsell; Shannon N Westin; Pedro T Ramirez; Michael Frumovitz; Pamela T Soliman Journal: J Gynecol Oncol Date: 2018-05-04 Impact factor: 4.401
Authors: Koji Matsuo; Shinya Matsuzaki; Rachel S Mandelbaum; Erica J Chang; Maximilian Klar; Kazuhide Matsushima; Brendan H Grubbs; Lynda D Roman; Jason D Wright Journal: Gynecol Oncol Date: 2020-05-27 Impact factor: 5.482
Authors: Koji Matsuo; Shinya Matsuzaki; Rachel S Mandelbaum; Kazuhide Matsushima; Maximilian Klar; Brendan H Grubbs; Lynda D Roman; Jason D Wright Journal: Gynecol Oncol Date: 2020-01-22 Impact factor: 5.482
Authors: Koji Matsuo; Erica J Chang; Shinya Matsuzaki; Rachel S Mandelbaum; Kazuhide Matsushima; Brendan H Grubbs; Maximilian Klar; Lynda D Roman; Anil K Sood; Jason D Wright Journal: Gynecol Oncol Date: 2020-05-10 Impact factor: 5.482
Authors: Tessa L Dinger; Hidde M Kroon; Luke Traeger; Sergei Bedrikovetski; Andrew Hunter; Tarik Sammour Journal: ANZ J Surg Date: 2022-05-03 Impact factor: 2.025