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
Sharma P. Riaz
Victoria H. Coupland
Professor Michael Lind M.J.Lind@hull.ac.uk
Foundation Professor of Oncology/ Head of the Joint Centre for Cancer Studies
Michael D. Peake
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.
|Journal Article Type||Article|
|Publication Date||Sep 1, 2013|
|Journal||Journal of Clinical Oncology|
|Publisher||American Society of Clinical Oncology|
|Peer Reviewed||Peer Reviewed|
|APA6 Citation||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. https://doi.org/10.1200/JCO.2013.49.0219|
|Copyright Statement||© 2013 by American Society of Clinical Oncology|
© 2013 by American Society of Clinical Oncology
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