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J. Gastrointest. Surg. · Jun 2010
Surgical outcomes associated with oesophagectomy in New South Wales: an investigation of hospital volume.
- Efty P Stavrou, Garett S Smith, and Deborah F Baker.
- Cancer Institute NSW, Monitoring, Evaluation and Research Unit, PO Box 41, Alexandria, NSW 1435, Australia. efty.stavrou@unsw.edu.au
- J. Gastrointest. Surg. 2010 Jun 1;14(6):951-7.
IntroductionResection remains the standard treatment for curable oesophageal cancer. By linking the NSW Central Cancer Registry (CCR) and the NSW Admitted Patient Data Collection (APDC) databases, mortality, post-resection complication and survival associated with oesophagectomy were investigated.MethodsAll patients diagnosed with oesophageal cancer from 2000 to 2005 as recorded in the CCR (n = 2,082) were linked with records in the APDC, giving a total of 17,205 episodes of care. Over 15% (n = 321) of all patients underwent an oesophagectomy.Results And DiscussionThe overall 30-day mortality rate following resection was 3.7%, ranging from 2.6% in high volume hospitals to 6.4% in low volume hospitals. Three-year absolute survival for localised-regional disease following oesophagectomy was 64% (95%CI 54-73%) in high-volume hospitals, 58% (95%CI 46-68%) in mid-volume and 45% (95%CI 23-65%) in low-volume hospitals. The post-resection complication rate was 19% (95%CI 13-26%) for high-volume hospital, 24% (95%CI 13-40%) in low-volume and 31% (95%CI 22-41%) in mid-volume hospitals.ConclusionOesophagectomy in NSW is performed with satisfactory results. However, there is a suggestion that higher- rather than lower-volume hospitals have better post-resection outcomes.
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