More Doesn't Always Mean Better Surgery

Esophageal cancer surgery volume does not impact outcomes

(RxWiki News) Does volume equate to quality? If a hospital performs more surgeries, it stands to reason that patient outcomes are better, right? Not necessarily.

Volume of procedures does not add up to better quality or patient outcomes, according to a recent review of esophageal cancer surgeries.

"Ask your surgeon how many of your surgeries s/he has performed."

Insurance companies have a tendency to refer esophageal cancer patients to hospitals that have a large volume of esophageal resections (surgical removal of all or part of the esophagus).

To see if there was an association between volume and outcome, thoracic surgeon Benjamin D. Kozower, MD, MPH and George J. Stukenborg, PhD, MA, both from the University of Virginia School of Medicine reviewed the records of a total of 6,248 esophageal cancer resection patients from 217 hospitals.

Hospital volume was measured. This volume was then compared to the mortality risks, which were adjusted for various factors including age, other conditions/diseases the patients had and other specific events.

Mortality risks were not associated with the hospital procedure volumes.

The authors concluded, "Esophageal cancer resection volume is not a significant predictor of mortality and should not be used as a proxy measure for surgical quality."

A report of this study was published in the May 2012 issue of The Annals of Thoracic Surgery.

Financial disclosures and funding information were not publicly available.

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Review Date: 
May 25, 2012