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Surgical specialty, surgical unit volume, and mortality after oesophageal cancer surgery
European Journal of Surgical Oncology, 06/26/09

Leigh Y et al. - In a trial to investigate the effects of surgical specialty and volume on mortality after oesophagectomy, it was shown that pts treated by general surgeons in low-volume hospitals had worse mortality outcomes than those treated by general surgeons in high-volume hospitals or by cardiothoracic surgeons. This is important because a majority of pts who underwent oesophagectomy for cancer were in this high-mortality risk group.

Methods

Hospital Episode Statistics for oesophagectomy were analyzed for cancer (n=9034 cases), linked to data from death certificates, in England from 1998 to 2003.

Results

After adjustment for pts' age, sex, and deprivation score, the odds ratio (OR) for death of general surgeons' (GS) pts, compared with cardiothoracic surgeons' (CTS) pts, was significantly high: 1.62 at 90 days.
Odds ratio for high-volume GS pts was not significantly different from that for high-volume CTS pts.
Odds ratio for low-volume GS pts vs high-volume CTS pts was significantly high: 1.72 at 30 days and 1.48 at 90 days.

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