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No Influence of Surgical Volume on Patients’ Health-Related Quality of Life After Esophageal Cancer Resection

  • Healthcare Policy and Outcomes
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Studies on factors that can counteract the negative impact of esophagectomy on patients’ health-related quality of life (HRQL) have been sparse. This study was undertaken to examine the question whether hospital or surgeon volume influences HRQL as evaluated 6 months after such surgery.

Materials and Methods

A Swedish prospective, population-based cohort study of esophageal cancer patients treated surgically in 2001–2005 was conducted. All patients completed validated HRQL questionnaires, developed by EORTC, addressing general HRQL (QLQ-C30) and esophageal-specific symptoms (QLQ-OES18), 6 months postoperatively. Mean scores with 95% confidence intervals were calculated. Clinically relevant mean score differences (≥10) between groups were further analyzed in a linear regression model, adjusted for several potential confounders.

Results

Some 355 patients were included (80% of eligible). No clinically relevant differences were found between low-volume (0–9 operations/year) and high-volume hospitals (>9 operations/year) or between low-volume (0–6 operations/year) and high-volume surgeons (>6 operations/year). Stratified analyses for tumor location did not reveal any differences between hospital or surgeon volume groups. Moreover, no material differences were found between the four individual high-volume hospitals.

Conclusion

This study revealed no HRQL advantages of being treated at high-volume hospitals or by high-volume surgeons, as measured 6 months after esophageal cancer resection.

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Acknowledgments

We acknowledge the support of the Swedish Cancer Society. We are also grateful to Eja Fridsta for invaluable help with the fieldwork of the Swedish Esophageal and Cardia Cancer (SECC) register. We sincerely appreciate the collaboration of all contact doctors participating in the SECC register, namely Erik Aasberg, Gunnar Adell, Stig-Olof Almgren, Christer Andersson, Bengt Anesten, Ebbe Ankeraa, Lena Appelgren, John Blomberg, Bernt Boeryd, Poul Boiesen, Mogens Bove, Mats Broberg, Pawel Burian, Björn Bäckstrand, Tora Campbell-Chiru, Ulf Carlsson, Åke Dahlqvist, Jan Dalenbäck, Stefan Dedorson, Jan Dolata, Thomas Edekling, Kent Edin, Tom Ekstrand, Annika Elmhorn Rosenborg, Lars-Krister Enander, Mats Eriksson, Thomas Eriksson, Bo Erlandsson, Ivan Farago, Elisabeth Flashar Lindahl, Petra Flygare, Ulla Friberg, Signe Friesland, Ashok Gadré, Ulf Gerdes, Per Gullstrand, Olle Gunder, Gustav Gustavsson, Mehmet Gözen, Andrea Halasz, Marianne Hall Angerås, Ann Hammarlund, Jörgen Hansen, Poul Erik Hansen, Mats Hedberg, Lennart Hedenborg, Antti Heikkilä, Per Herlin, Leif Hoffmann-Laursen, Erik Holm, Fredrik Holmner, Hans-Olof Håkansson, Hans Högström, Leif Ingvarsson, Peter Jilcke, Bengt Johansson, Karl-Erik Johansson, Leif Johansson, Sven Johansson, Erik Johnsson, Göran Karlsson, Mats Karlsson, Staffan Kinman, Gerhard Kjellén, Wieslava Kranze, Hans Krook, Richard Kuylenstierna, Anders Kylebäck, Peter Lannes, Sven Larsson, Gustav Levin, Pontus Lidberg, Bengt Liedman, Håkan Liljeholm, Ramon Lillo-Gil, Daniel Lindahl, Gert Lindell, Christer Lindholm, Johan Lindholm, Christina Lindström, Gunilla Ljung, Anders Lundberg, Kjell Lundberg, Lars Lundell, Britta Lödén, Ulf Lönn, Ester Lörinc, Shabaz Majid, Janusz Matusik, Kai Melén, Lennart Mellblom, Hans Modig, Eva Munck-Wikland, Torbjörn Myrnäs, Ewa Mårtensson, Torben Navne, Anders Nihlberg, Erik Nilsson, Mats Nilsson, Roland Nilsson, Torgny Nordén, Tomas Norlander, Johan Nyman, Ingmar Näslund, Bengt Ohlander, Bo Ojen, Sante Olling, Bengt Olsson, Håkan Olsson, Mikael Olsson, Rickard Palmkvist, Fredrik Petersson, Johan Ramström, Gunnar Rimbäck, Pehr Rissler, Staffan Rosendahl, Claes Rudberg, Valter Ryd, Thure Rådmark, Björn Sandmark, Charles Silseth, Svante Sjöstedt, Stefan Spinnell, Roger Stenling, Dag Stockeld, Edith Stöckel, Magnus Sundblad, Erik Svartholm, Conny Svensson, Jan-Olov Svensson, Robert Szepesvari, Claes Söderlund, Claes Theander, Stefan Thelin, Maria Thorén Örnberg, Tibor Tot, Torbjörn Tuveson, Maciej Tytor, Sören Vallgren, Svend Vang Petersen, Anders Victorin, Torkel Wahlin, Kjell Wallin, Bruno Walther, Olle Wihlborg, Bo J Wilhelmsson, Åke Östh, and Görel Östberg.

Conflict of interest statement

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Molecular Medicine and Surgery, Unit of Esophageal and Gastric Research (ESOGAR), Karolinska Institutet, Stockholm, Sweden

    Martin Rutegård & Pernilla Lagergren RN, PhD

  2. Department of Surgery, P9:03, Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden

    Martin Rutegård

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  1. Martin Rutegård
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  2. Pernilla Lagergren RN, PhD
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Correspondence to Martin Rutegård.

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Rutegård, M., Lagergren, P. No Influence of Surgical Volume on Patients’ Health-Related Quality of Life After Esophageal Cancer Resection. Ann Surg Oncol 15, 2380–2387 (2008). https://doi.org/10.1245/s10434-008-9964-4

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  • DOI: https://doi.org/10.1245/s10434-008-9964-4

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