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Design
Review
May guide referrals to high-volume centers; leaves open prospective validation of survival benefits.
Historical reviews of outcome following major operations for cancer have focused on the readily measurable, operative mortality. The interrelationship of surgeon and institutional volume to improved perioperative outcome has been confirmed. More current studies now relate long term cancer survival to other issues of specialization, volume, payor and institution. The challenge is to determine what volume thresholds are sufficient for acceptable outcomes.
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Brennan et al. (2009) studied this question.
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