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June 24, 2008Journal of Clinical Oncology

Directing Surgical Quality Improvement Initiatives: Comparison of Perioperative Mortality and Long-Term Survival for Cancer Surgery

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Why the study?

Does hospital surgical volume have a larger effect on perioperative mortality or long-term survival in patients undergoing cancer surgery?

Population

243,103 patients who underwent surgery for nonmetastatic colon, esophageal, gastric, liver, lung…

Comparison

Surgery at high-volume hospitals vs Surgery at low-volume hospitals

Design

Cohort

Follow-up

60 days and 5 years

Authors

KBKarl Y. BilimoriaDBDavid J. BentremJFJoseph Feinglass

Discussion

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Overview

May warrant prioritizing long-term survival factors in cancer surgery quality efforts; extends volume-outcome observations but requires prospective validation.

Structured PICO

Does hospital surgical volume have a larger effect on perioperative mortality or long-term survival in patients undergoing cancer surgery?

P
Population
243,103 patients who underwent surgery for nonmetastatic colon, esophageal, gastric, liver, lung, pancreatic, or rectal cancer
I
Intervention
Surgery at high-volume hospitals
C
Comparator
Surgery at low-volume hospitals
O
Outcome
60-day mortality and 5-year conditional survival (excluding perioperative deaths)hard clinical

Quality-improvement initiatives in cancer surgery could avoid a larger number of deaths by focusing on factors associated with long-term survival rather than just perioperative mortality.

Cite This Study

Bilimoria et al. (2008) studied this question.

synapsesocial.com/papers/6a7a9dca02ab7a73dd0301cahttps://doi.org/10.1200/jco.2007.15.6356
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hospital Volume and Surgical Mortality in the United States2002 · 5,017 citations
  2. 2Surgeon Volume and Operative Mortality in the United States2003 · 3,123 citations
  3. 3Patient Preferences for Location of Care1999 · 460 citations
  4. 4Achieving And Sustaining Improved Quality: Lessons From New York State And Cardiac Surgery2002 · 308 citations
  5. 5Association of Surgical Specialty and Processes of Care With Patient Outcomes for Carotid Endarterectomy2001 · 125 citations