The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 1 , Pages 23-29 , January 2009

The effect of volume on esophageal cancer resections: What constitutes acceptable resection volumes for centers of excellence?

  • Robert A. Meguid, MD, MPH

      Affiliations

    • Division of Thoracic Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • Corresponding Author InformationAddress for reprints: Robert A. Meguid, MD, MPH, Division of Thoracic Surgery, Department of Surgery, 600 N. Wolfe St, Blalock 240, The Johns Hopkins Hospital, Baltimore, MD 21287.
    • ,
  • Eric S. Weiss, MD

      Affiliations

    • Division of Thoracic Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • David C. Chang, PhD, MPH, MBA

      Affiliations

    • Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Malcolm V. Brock, MD

      Affiliations

    • Division of Thoracic Surgery, Johns Hopkins School of Medicine, Baltimore, Md
    • ,
  • Steven C. Yang, MD

      Affiliations

    • Division of Thoracic Surgery, Johns Hopkins School of Medicine, Baltimore, Md

Received 5 May 2007 ,Revised 20 June 2008 ,Accepted 16 September 2008.

References 

  1. Luft HS, Bunker JP, Enthoven AC. Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med. 1979;301:1364–1369
  2. Begg CB, Cramer LD, Hoskins WJ, Brennan MF. Impact of hospital volume on operative mortality for major cancer surgery. JAMA. 1998;280:1747–1751
  3. Dimick JB, Cattaneo SM, Lipsett PA, Pronovost PJ, Heitmiller RF. Hospital volume is related to clinical and economic outcomes of esophageal resection in Maryland. Ann Thorac Surg. 2001;72:334–341
  4. Kuo EY, Chang Y, Wright CD. Impact of hospital volume on clinical and economic outcomes for esophagectomy. Ann Thorac Surg. 2001;72:1118–1124
  5. Leapfrog Group “Evidence-based hospital referral” for esophageal cancer. 2003. Available at: leapfroggroup.org. Accessed November 21, 2006.
  6. Chang AC, Birkmeyer JD. The volume-performance relationship in esophagectomy. Thorac Surg Clin. 2006;16:87–94
  7. Milstein A, Galvin RS, Delbanco SF, Salber P, Buck CR. Improving the safety of health care: the leapfrog initiative. Eff Clin Pract. 2000;3:313–316
  8. Healthcare Cost and Utilization Project (HCUP): Nationwide Inpatient Sample. Rockville, MD: Agency for Healthcare Research and Quality; 2005;
  9. Ahuja N, Chang D, Gearhart SL. Disparities in colon cancer presentation and in-hospital mortality in Maryland: a ten-year review. Ann Surg Oncol. 2007;14:411–416
  10. International Classification of Diseases, Ninth Revision, Ninth Edition. Washington, DC: Public Health Service, US Department of Health and Human Services; 1988;
  11. Casson AG, van Lanschot JJ. Improving outcomes after esophagectomy: the impact of operative volume. J Surg Oncol. 2005;92:262–266
  12. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–383
  13. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613–619
  14. Romano PS, Roos LL, Jollis JG. Adapting a clinical comorbidity index for use with ICD-9-CM administrative data: differing perspectives. J Clin Epidemiol. 1993;46:1075–1079discussion 1081-90
  15. Allison PD. Comparing logit and probit coefficients across groups. Sociol Methods Res. 1999;28:186–208
  16. Long JS, Freese J. Regression Models for Categorical Dependent Variables Using Stata. 2nd ed. College Station, TX: Stata Press; 2006;
  17. Long JS. Regression Models for Categorical and Limited Dependent Variables. Thousand Oaks, CA: Sage Publications; 1997;
  18. Christian CK, Gustafson ML, Betensky RA, Daley J, Zinner MJ. The Leapfrog volume criteria may fall short in identifying high-quality surgical centers. Ann Surg. 2003;238:447–457
  19. Bailey SH, Bull DA, Harpole DH, Rentz JJ, Neumayer LA, Pappas TN, et al. Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg. 2003;75:217–222
  20. Birkmeyer JD, Dimick JB. Potential benefits of the new Leapfrog standards: effect of process and outcomes measures. Surgery. 2004;135:569–575
  21. Billingsley KG, Morris AM, Dominitz JA, Matthews B, Dobie S, Barlow W, et al. Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery: understanding the volume-outcome relationship. Arch Surg. 2007;142:23–32
  22. Angus DC, Shorr AF, White A, Dremsizov TT, Schmitz RJ, Kelley MA. Critical care delivery in the United States: distribution of services and compliance with Leapfrog recommendations. Crit Care Med. 2006;34:1016–1024
  23. Makary MA, Sexton JB, Freischlag JA, Millman EA, Pryor D, Holzmueller C, et al. Patient safety in surgery. Ann Surg. 2006;243:628–635
  24. Zehr KJ, Dawson PB, Yang SC, Heitmiller RF. Standardized clinical care pathways for major thoracic cases reduce hospital costs. Ann Thorac Surg. 1998;66:914–919
  25. Birkmeyer JD, Sun Y, Goldfaden A, Birkmeyer NJ, Stukel TA. Volume and process of care in high-risk cancer surgery. Cancer. 2006;106:2476–2481
  26. Hannan EL, Popp AJ, Feustel P, Halm E, Bernardini G, Waldman J, et al. Association of surgical specialty and processes of care with patient outcomes for carotid endarterectomy. Stroke. 2001;32:2890–2897

 Drs Robert A. Meguid and Eric S. Weiss were supported by the Ruth L. Kirschstein National Research Service Award (T32DK007713) while undertaking this study. Dr Eric S. Weiss is an Irene Piccinini Investigator in Cardiac Surgery.

 Read at the Eighty-seventh Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 5-9, 2007.

PII: S0022-5223(08)01635-8

doi: 10.1016/j.jtcvs.2008.09.040

The Journal of Thoracic and Cardiovascular Surgery
Volume 137, Issue 1 , Pages 23-29 , January 2009

Article Tools

* Image Usage & Resolution