Title :

Specificity of Procedure volume and its Association With Postoperative Mortality in Digestive Cancer Surgery

Author(s) :

El Amrani, Mehdi [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Lenne, Xavier [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Clement, Guillaume [Auteur]
Centre de recherche sur les Ions, les MAtériaux et la Photonique [CIMAP - UMR 6252]
Delpero, Jean-Robert [Auteur]
Institut Paoli-Calmettes [IPC]
Theis, Didier [Auteur]
Université Lille Nord (France)
Pruvot, François-René [Auteur]
Hôpital Claude Huriez [Lille]
Bruandet, Amelie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Truant, Stéphanie [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]

Journal title :

Annals of Surgery

Pages :

775-782

Publisher :

Lippincott, Williams & Wilkins

Publication date :

2019-11

ISSN :

0003-4932

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Objectives: We aimed to examine whether the improved outcome of a digestive cancer procedure in high-volume hospitals is specific or correlates with that of other digestive cancer procedures, and determine if the discriminant ...
Show more >Objectives: We aimed to examine whether the improved outcome of a digestive cancer procedure in high-volume hospitals is specific or correlates with that of other digestive cancer procedures, and determine if the discriminant cut-off of hospital volume may influence postoperative mortality (POM) regardless of the procedure. Background: Performing complex surgeries in tertiary centers is associated with improved outcome. However, the association between POM and hospital volume of nonspecific procedures is unknown. Methods: Patients who underwent colectomy, proctectomy, esophagectomy, gastrectomy, pancreatectomy, and hepatectomy for cancer between 2012 and 2017 were identified in the French nationwide database. Chi-square automatic interaction detector was used to identify the cut-off values of the annual caseload affecting the 90-day POM. A common threshold was estimated by minimization of chi-square distance taking into account the specific mortality of each procedure. Results: Overall, 225,752 patients were identified. Hospitals were categorized according to the procedure volume (colectomy: ≥80 cases/yr, proctectomy: ≥35/yr, esophagectomy: ≥41/yr, gastrectomy: ≥16/yr, pancreatectomy: ≥26/yr, and hepatectomy: ≥76/yr). The overall 90-day POM was 5.1% and varied significantly with volume. The benefits of high volume were transferable across procedures. High-volume hospitals for colorectal cancer surgery significantly influenced the risk of death after hepatectomy ( P < 0.001) and pancreatectomy ( P < 0.001). The common threshold for all procedures that influenced POM was 199 cases/yr (odds ratio 1.29, P < 0.001). Conclusion: In digestive cancer surgery, the volume–POM relationship of one procedure was associated with the volume of other procedures. Thus, tertiary hospitals should be defined according to the common threshold of different procedures.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL