Survival, mortality and morbidity outcomes after oesophagogastric cancer surgery in New South Wales, 2001-2008.
Med J Aust
; 200(7): 408-13, 2014 Apr 21.
Article
em En
| MEDLINE
| ID: mdl-24794674
ABSTRACT
OBJECTIVES:
To examine the relationship between hospital volume and patient outcomes for New South Wales hospitals performing oesophagectomy and gastrectomy for oesophagogastric cancer. DESIGN, SETTING AND PATIENTS A retrospective, population-based cohort study of NSW residents diagnosed with a new case of invasive oesophageal or gastric cancer who underwent oesophagectomy or gastrectomy between 2001 and 2008 in NSW hospitals using linked de-identified data from the NSW Central Cancer Registry, the National Death Index and the NSW Admitted Patient Data Collection. A higher-volume hospital was defined as one performing > 6 relevant procedures per year. MAIN OUTCOMEMEASURES:
Odds ratios for > 21-day length of stay, 28-day unplanned readmission, 30-day mortality and 90-day mortality, and hazard ratios (HRs) for 5-year absolute and conditional survival.RESULTS:
Oesophagectomy (908 patients) and gastrectomy (1621 patients) were undertaken in 42 and 84 hospitals, respectively, between 2001 and 2008. Median annual hospital volume ranged from 2 to 4 for oesophagectomies and ranged from 2 to 3 for gastrectomies. Controlling for known confounders, no associations between hospital volume and > 21-day length of stay and 28-day unplanned readmission were found. Overall 30-day mortality was 4.1% and 4.4% for oesophagectomy and gastrectomy, respectively. Five-year absolute survival was significantly better for patients who underwent oesophagectomy in higher-volume hospitals (adjusted HR for lower-volume hospitals, 1.28 [95% CI, 1.10-1.49]; P = 0.002) and for those with localised gastric cancer who underwent gastrectomy in higher-volume hospitals (adjusted HR for lower-volume hospitals, 1.83 [95% CI, 1.28-2.61]; P = 0.001).CONCLUSIONS:
These data support initial surgery for oesophagogastric cancer in higher-volume hospitals.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
/
Neoplasias Esofágicas
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Esofagectomia
/
Gastrectomia
/
Tempo de Internação
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article