Hospital volume and postoperative survival for three urological cancers: Prostate, kidney, and bladder.

OBJECTIVE: To examine the association between hospital volume and postoperative 5-year survival for patients with prostate, kidney, and bladder cancer. METHOD: Using Osaka Cancer Registry data, we identified 9285 patients who were diagnosed as having prostate, kidney, or bladder cancer and who underwent surgery between 2007 and 2011 in Osaka, Japan. The surgical hospital volume of each hospital was calculated and then divided into quartiles (high, medium, low, very low). We estimated the hazard ratios of hospital volume (quartiles) for 5-year survival using Cox proportional hazard models. RESULTS: For all three cancer sites, the mortality hazard of hospitals with the lowest hospital volume was significantly higher than that of hospitals with the highest volume. The difference in adjusted 5-year survival rates between hospitals with the highest and lowest hospital volume was 3.6% for prostate cancer, 6.6% for kidney cancer, and 13.3% for bladder cancer. CONCLUSION: Hospital surgical volume seems to affect 5-year survival for patients with urological cancers, especially kidney and bladder cancer.