Updates in Surgery

, Volume 63, Issue 3, pp 147–150 | Cite as

Should esophageal resections for cancer be performed in high-volume centers only?

  • Carlo V. Feo
  • Victoria M. Villaflor
  • Marco G. Patti
Review Article

Abstract

Esophageal resection remains the only curative option for esophageal cancer, and therefore, improving the outcome of surgery is the best method of reducing mortality. Several studies have evaluated the postoperative morbidity and mortality after esophageal resection, analyzing the relationship between volume or surgical experience and operative mortality. In this article, the evidence supporting the referral of esophageal surgery to centers with a greater experience (i.e., high-volume centers) is reviewed in order to establish the best practice.

Keywords

Esophageal cancer Esophagectomy Hospital mortality Postoperative complications Treatment outcome 

Abbreviations

AIRTUM

Italian Network of Cancer Registries

CABG

Coronary artery bypass graft

Notes

Conflict of interest

The authors have no conflicts of interest to declare.

References

  1. 1.
    AIRTUM Working Group. Italian cancer figures–Report 2009 (2009) Epidemiol Rev 33:34-35Google Scholar
  2. 2.
    Swisher SG, Hunt KK L, Holmes EC, Zinner MJ, McFadden DW (1995) Changes in the surgical management of esophageal cancer from 1970 to 1993. Am J Surg 169:609–614PubMedCrossRefGoogle Scholar
  3. 3.
    Herbella FA, Patti MG (2010) Minimally invasive esophagectomy. World J Gastroenterol 16:3811–3815PubMedCrossRefGoogle Scholar
  4. 4.
    Patti MG, Corvera CU, Glasgow RE, Way LWW (1998) A hospital’s annual rate of esophagectomy influences the operative mortality rate. J Gastrointest Surg 2:186–192PubMedCrossRefGoogle Scholar
  5. 5.
    Swisher SG, DeFord L, Merriman KW, Walsh GL, Smythe R, Vaporicyan A, Ajani JA, Brown T, Komaki R, Roth J, Putman JB (2000) Effect of operative volume on morbidity, mortality, and hospital use after esophagectomy for cancer. J Thorac Cardiovasc Surg 119:1126–1134PubMedCrossRefGoogle Scholar
  6. 6.
    Gillison EW, Powell J, McConkey CC, Spychal RT (2002) Surgical workload and outcome after resection for carcinoma of the oesophagus and cardia. Br J Surg 89:344–348PubMedCrossRefGoogle Scholar
  7. 7.
    Wouters MW, Wijnhoven BP, Karim-Kos HE, Blaauwgeers HG, Stassen LP, Steup WH, Tilanus HW, Tollenaar RA (2008) High-volume versus low-volume for esophageal resections for cancer: the essential role of case-mix adjustments based on clinical data. Ann Surg Oncol 15:80–87PubMedCrossRefGoogle Scholar
  8. 8.
    Courrech Staal EFW, van Coevorden F, Cats A, Aleman BMP, van Velthuysen MLF, Boot H, Vrancken Peeters MJTFD, van Sandick JW (2009) Outcome of low-volume surgery for esophageal cancer in a high-volume referral center. Ann Surg Oncol 16:3219–3226PubMedCrossRefGoogle Scholar
  9. 9.
    Verhoef C, van de Weyer R, Schaapveld M, Bastiaannet E, Plukker JTM (2007) Better survival in patients with esophageal cancer after surgical treatment in university hospitals: a plea for performance by surgical oncologists. Ann Surg Oncol 14:1678–1687PubMedCrossRefGoogle Scholar
  10. 10.
    Dudley RA, Johansen KL, Brand R, Rennie DJ, Milstein A (2000) Selective referral to high-volume hospitals: estimating potentially avoidable deaths. JAMA 283:1159–1166PubMedCrossRefGoogle Scholar
  11. 11.
    Birkmeyer JD, Finlayson EV, Birkmeyer CM (2001) Volume standards for high-risk surgical procedures: potential benefits of the Leapfrog initiative. Surgery 130:415–422PubMedCrossRefGoogle Scholar
  12. 12.
    Birkmeyer JD, Dimick JB (2004) Potential benefits of the new Leapfrog standards: effect of process and outcomes measures. Surgery 135:569–575PubMedCrossRefGoogle Scholar
  13. 13.
    Gasper WJ, Glidden DV, Jin C, Way LW, Patti MG (2009) Has recognition of the relationship between mortality rates and hospital volume for major cancer surgery in California made a difference?: a follow-up analysis of another decade. Ann Surg 250:472–483PubMedGoogle Scholar
  14. 14.
    Ruol A, Castoro C, Portale G, Cavallin F, Chiarion Sileni V, Cagol M, Alfieri R, Corti L, Boso C, Zaninotto G, Peracchia A, Ancona E (2009) Trends in management and prognosis for esophageal cancer surgery: twenty-five years of experience at a single institution. Arch Surg 144:247–254PubMedCrossRefGoogle Scholar
  15. 15.
    Begg CB, Cramer LD, Hoskins WJ, Brennan MF (1998) Impact of hospital volume on operative mortality for major cancer surgery. JAMA 280:1747–1751PubMedCrossRefGoogle Scholar
  16. 16.
    Birkmeyer JD, Stukel TA, Siewers AE et al (2003) Surgeon volume and operative mortality in the United States. N Engl J Med 349:2117–2127PubMedCrossRefGoogle Scholar
  17. 17.
    Migliore M, Choong CK, Lim E, Goldsmith KA, Ritchie A, Wells F (2007) A surgeon’s case volume of oesophagectomy for cancer strongly influences the operative mortality rate. Eur J Cardiothorac Surg 32:375–380PubMedCrossRefGoogle Scholar
  18. 18.
    Hall BL, Hsiao EY, Majercik S, Hirbe M, Hamilton BH (2009) The impact of surgeon specialization on patient mortality: examination of a continuous Herfindahl–Hirschman index. Ann Surg 249:708–716PubMedCrossRefGoogle Scholar
  19. 19.
    Bartels H, Stein HJ, Siewert JR (1998) Preoperative risk analysis and postoperative mortality of oesophagectomy for resectable oesophageal cancer. Br J Surg 85:840–844PubMedCrossRefGoogle Scholar
  20. 20.
    Ferguson MK, Martin TR, Reeder LB, Olak J (1997) Mortality after esophagectomy: risk factor analysis. World J Surg 21:599–603PubMedCrossRefGoogle Scholar
  21. 21.
    Birkmeyer JD, Dimick JB (2009) Understanding and reducing variation in surgical mortality. Annu Rev Med 60:405–415PubMedCrossRefGoogle Scholar
  22. 22.
    Hannan EL, Kilburn H Jr, Racz M, Shields E, Chassin MR (1994) Improving the outcomes of coronary artery bypass surgery in New York State. JAMA 271:761–766PubMedCrossRefGoogle Scholar
  23. 23.
    Chassin MR (2002) Achieving and sustaining improved quality: lessons from New York State and cardiac surgery. Health Aff 21:40–51CrossRefGoogle Scholar
  24. 24.
    Dixon E, Bathe OF, McKay A, You I, Dowden S, Sadler D, Burak KW, McKinnon JG, Miller W, Sutherland FR (2009) Population-based review of the outcomes following hepatic resection in a Canadian health region. Can J Surg 52:12–17PubMedGoogle Scholar
  25. 25.
    Birkmeyer JD, Sun Y, Wong SL, Stukel TA (2007) Hospital volume and late survival after cancer surgery. Ann Surg 245:777–783PubMedCrossRefGoogle Scholar
  26. 26.
    Fong Y, Gonen M, Rubin D, Radzyner M, Brennan MF (2005) Long-term survival is superior after resection for cancer in high-volume centers. Ann Surg 242:540–547PubMedGoogle Scholar
  27. 27.
    Bilimoria KY, Bentrem DJ, Feinglass JM, Stewart AK, Winchester DP, Talamonti MS, Ko CY (2008) Directing surgical quality improvement initiatives: comparison of perioperative mortality and long-term survival for cancer surgery. J Clin Oncol 26:4626–4633PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Carlo V. Feo
    • 1
    • 4
  • Victoria M. Villaflor
    • 2
  • Marco G. Patti
    • 3
  1. 1.Department of SurgeryUniversity of Ferrara and University Hospital of FerraraFerraraItaly
  2. 2.Section of Hematology/OncologyUniversity of Chicago Pritzker School of MedicineChicagoUSA
  3. 3.Department of SurgeryUniversity of Chicago Pritzker School of MedicineChicagoUSA
  4. 4.Clinica ChirurgicaAzienda Ospedaliero-Universitaria di FerraraFerraraItaly

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