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High procedure volume is strongly associated with improved survival after lung cancer surgery

Lüchtenborg, Margreet; Riaz, Sharma P.; Coupland, Victoria H.; Lim, Eric; Jakobsen, Erik; Krasnik, Mark; Page, Richard; Lind, Michael J.; Peake, Michael D.; Møller, Henrik


Margreet Lüchtenborg

Sharma P. Riaz

Victoria H. Coupland

Eric Lim

Erik Jakobsen

Mark Krasnik

Richard Page

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Professor Michael Lind
Foundation Professor of Oncology/ Head of the Joint Centre for Cancer Studies

Michael D. Peake

Henrik Møller


Studies have reported an association between hospital volume and survival for non–small-cell lung cancer (NSCLC). We explored this association in England, accounting for case mix and propensity to resect.

We analyzed data on 134,293 patients with NSCLC diagnosed in England between 2004 and 2008, of whom 12,862 (9.6%) underwent surgical resection. Hospital volume was defined according to number of patients with resected lung cancer in each hospital in each year of diagnosis. We calculated hazard ratios (HRs) for death in three predefined periods according to hospital volume, sex, age, socioeconomic deprivation, comorbidity, and propensity to resect.

There was increased survival in hospitals performing > 150 surgical resections compared with those carrying out < 70 (HR, 0.78; 95% CI, 0.67 to 0.90; Ptrend < .01). The association between hospital volume and survival was present in all three periods of follow-up, but the magnitude of association was greatest in the early postoperative period.

High-volume hospitals have higher resection rates and perform surgery among patients who are older, have lower socioeconomic status, and have more comorbidities; despite this, they achieve better survival, most notably in the early postoperative period.


Lüchtenborg, M., Riaz, S. P., Coupland, V. H., Lim, E., Jakobsen, E., Krasnik, M., …Møller, H. (2013). High procedure volume is strongly associated with improved survival after lung cancer surgery. Journal of Clinical Oncology, 31(25), 3141-3146.

Journal Article Type Article
Acceptance Date Jul 1, 2013
Publication Date Sep 1, 2013
Deposit Date Aug 8, 2018
Publicly Available Date Oct 27, 2022
Journal Journal of Clinical Oncology
Print ISSN 0732-183X
Electronic ISSN 1527-7755
Publisher American Society of Clinical Oncology
Peer Reviewed Peer Reviewed
Volume 31
Issue 25
Pages 3141-3146
Public URL
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