Document Detail


Hospital volume: operative morbidity, mortality and survival in thoracotomy for lung cancer. A Spanish multicenter study of 2994 cases.
MedLine Citation:
PMID:  16343923     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: It has been hypothesized that medical procedures performed in high-volume units carry less risk and achieve a better outcome. OBJECTIVE: To determine the relationship between the number of interventions and the operative morbidity, mortality and long-term survival in the surgery of bronchogenic carcinoma (BC). PATIENTS AND METHOD: Prospective, multicenter Spanish study was conducted in 19 departments of thoracic surgery on 2994 patients operated on consecutively with the aim of curing BC. The thoracic surgery departments have been classified into three groups, according to the number of interventions performed per year: I (1-43 cases/year; centers=7; n=565; 18.9%), II (44-54 cases/year; centers=6; n=1044; 34.9%) and III (55 or more cases/year; centers=6; n=1385; 46.3%). RESULTS: When the three groups were compared, the frequency of complete surgery was found to be 84% for group I, 76% for group II and 83% for group III (p=0.001, for comparisons between groups I/II and II/III). The pathological stages were identical in the three groups. The overall morbidity and the mortality in all patients or above the age of 75 or in pneumonectomies were not different among the groups. When considering all the patients with prognostic information (n=2758), no differences were found regarding the 5-year survival among the groups. When only patients in postoperative stage I-II and complete resection were evaluated, excluding operative mortality (n=1128), 5-year survival was 0.58 for group I, 0.57 for group II and 0.50 for group III (p=0.06 between groups II and III; p=0.08 between groups I and III). CONCLUSIONS: No significant differences that do not favor the hypothesis that there is increased surgical risk and worse survival in centers having a lower volume were found in this Spanish multicenter study.
Authors:
Jorge L Freixinet; Gabriel Julià-Serdà; Pedro M Rodríguez; Norberto B Santana; Felipe Rodríguez de Castro; María Dolores Fiuza; Angel López-Encuentra;
Related Documents :
7979783 - Profile of preoperative characteristics of patients having cabg over the past decade.
6121483 - Severe left main coronary arterial stenosis with right coronary arterial occlusion: res...
14975553 - Reoperations in adults with congenital heart disease: analysis of early outcome.
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2005-12-15
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  29     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-26     Completed Date:  2006-03-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  20-5     Citation Subset:  IM    
Affiliation:
Hospital de Gran Canaria Dr. Negrín, Barranco de la Ballena s/n, 35020 Las Palmas de Gran Canaria, Canary Islands, Spain.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoma, Bronchogenic / epidemiology*,  mortality,  surgery
Female
Hospital Mortality
Humans
Lung Neoplasms / epidemiology*,  mortality,  surgery
Male
Morbidity
Postoperative Complications / epidemiology,  mortality
Prospective Studies
Risk Factors
Spain / epidemiology
Survival Analysis
Thoracotomy / adverse effects,  mortality*,  utilization
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Non-invasive diagnostic of cardiac allograft vasculopathy by 31P magnetic resonance chemical shift i...
Next Document:  Multimodality approach in management of malignant pleural mesothelioma.