Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Møller, H; Riaz, SP; Holmberg, L; Jakobsen, E; Lagergren, J; Page, R; Peake, MD; Pearce, N; Purushotham, A; Sullivan, R; Vedsted, P; Luchtenborg, M (2016)
Publisher: Elsevier
Languages: English
Types: Article
Subjects: lung cancer; procedure volume; surgery; epidemiology; cohort study
It is debated whether treating cancer patients in high-volume surgical centres can lead to improvement in outcomes, such as shorter length of hospital stay, decreased frequency and severity of postoperative complications, decreased re-admission, and decreased mortality.

The dataset for this analysis was based on cancer registration and hospital discharge data and comprised information on 15,738 non-small cell lung cancer patients resident and diagnosed in England in 2006-2010 and treated by surgical resection. The number of lung cancer resections was computed for each hospital in each calendar year, and patients were assigned to a hospital volume quintile on the basis of the volume of their hospital.

Hospitals with large lung cancer surgical resection volumes were less restrictive in their selection of patients for surgical management, and provided a higher resection rate to their geographical population. Higher volume hospitals had shorter length of stay and the odds of re-admission were 15% lower in the highest hospital volume quintile compared with the lowest quintile. Mortality risks were 1% after 30 days and 3% after 90 days. Patients from hospitals in the highest volume quintile had about half the odds of death within 30 days than patients from the lowest quintile.

Variations in outcomes were generally small, but in the same direction, with consistently better outcomes in the larger hospitals. This gives support to the ongoing trend towards centralisation of clinical services, but service re-organisation needs to take account of not only the size of hospitals but also referral routes and patient access.
  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • study in England 2004-2006. Eur J Cancer. 2012 Jan;48(1):54-60. doi:
    • 10.1016/j.ejca.2011.07.012. Epub 2011 Aug 24. PubMed PMID: 21871792. 10. Walters S, Benitez-Majano S, Muller P, Coleman MP, Allemani C, Butler J, Peake M,
    • international gap in cancer survival? Br J Cancer. 2015 Sep 1;113(5):848-60. doi:
    • 10.1038/bjc.2015.265. Epub 2015 Aug 4. PubMed PMID: 26241817; PubMed Central
    • PMCID: PMC4559829. 11. Lüchtenborg M, Riaz SP, Coupland VH, Lim E, Jakobsen E, Krasnik M, Page R, Lind MJ,
    • survival after lung cancer surgery. J Clin Oncol. 2013 Sep 1;31(25):3141-6. doi:
    • 10.1200/JCO.2013.49.0219. Epub 2013 Jul 29. PubMed PMID: 23897962. 12. National Lung Cancer Audit
    • https://www.rcplondon.ac.uk/projects/national-lung-cancer-audit 13. Cheung MC, Hamilton K, Sherman R, Byrne MM, Nguyen DM, Franceschi D, Koniaris LG.
    • resection: an examination of 13,469 surgical patients. Ann Surg Oncol. 2009 Jan;16(1):3-
    • 13. doi: 0.1245/s10434-008-0025-9. Epub 2008 Jul 4. PubMed PMID: 18600379. 14. Learn PA, Bach PB. A decade of mortality reductions in major oncologic surgery: the
    • impact of centralization and quality improvement. Med Care. 2010 Dec;48(12):1041-9.
    • doi: 0.1097/MLR.0b013e3181f37d5f. PubMed PMID: 20966781. 15. Finks JF, Osborne NH, Birkmeyer JD. Trends in hospital volume and operative mortality
    • for high-risk surgery. N Engl J Med. 2011 Jun 2;364(22):2128-37. doi:
    • 10.1056/NEJMsa1010705. PubMed PMID: 21631325; PubMed Central PMCID:
    • PMC3150488. 16. Coupland VH, Lagergren J, Lüchtenborg M, Jack RH, Allum W, Holmberg L, Hanna GB,
    • oesophageal and gastric cancer: a population-based study in England, 2004-2008. Gut.
    • 2013 Jul;62(7):961-6. doi: 10.1136/gutjnl-2012-303008. Epub 2012 Oct 19. PubMed
    • PMID: 23086798. 17. Pezzi CM, Mallin K, Mendez AS, Greer Gay E, Putnam JB Jr. Ninety-day mortality after
    • resection for lung cancer is nearly double 30-day mortality. J Thorac Cardiovasc Surg.
    • 2014 ov;148(5):2269-77. doi: 10.1016/j.jtcvs.2014.07.077. Epub 2014 Aug 4. PubMed
    • PMID: 25172318. 18. Otake H, Yasunaga H, Horiguchi H, Matsutani N, Matsuda S, Ohe K. Impact of hospital
    • Thorac Surg. 2011 Sep;92(3):1069-74. doi: 10.1016/j.athoracsur.2011.04.087. PubMed
    • PMID: 21871302. 19. Handy JR Jr, Denniston K, Grunkemeier GL, Wu YX. What is the inpatient cost of hospital
    • complications or death after lobectomy or pneumonectomy? Ann Thorac Surg. 2011
    • Jan;91(1):234-8. doi: 10.1016/j.athoracsur.2010.08.043. PubMed PMID: 21172519. 20. Park HS, Detterbeck FC, Boffa DJ, Kim AW. Impact of hospital volume of thoracoscopic
    • lobectomy on primary lung cancer outcomes. Ann Thorac Surg. 2012 Feb;93(2):372-9.
    • doi: 10.1016/j.athoracsur.2011.06.054. Epub 2011 Sep 25. PubMed PMID: 21945225. 21. Kelly M, Sharp L, Dwane F, Kelleher T, Drummond FJ, Comber H. Factors predicting
    • Health Serv Res. 2013 Jul 2;13:244. doi: 10.1186/1472-6963-13-244. PubMed PMID:
    • 23816338; PubMed Central PMCID: PMC3750445. 22. McDevitt J, Kelly M, Comber H, Kelleher T, Dwane F, Sharp L. A population-based study
    • cell lung cancer. Eur J Cardiothorac Surg. 2013 Oct;44(4):e253-9. doi:
    • 10.1093/ejcts/ezt389. Epub 2013 Jul 25. PubMed PMID: 23886994; PubMed Central
    • PMCID: PMC4036404. 23. Rosen JE, Hancock JG, Kim AW, Detterbeck FC, Boffa DJ. Predictors of mortality after
    • 2014 Dec;98(6):1953-60. doi: 10.1016/j.athoracsur.2014.07.007. Epub 2014 Oct 18.
    • PubMed PMID: 25443003. 24. Hu Y, McMurry TL, Isbell JM, Stukenborg GJ, Kozower BD. Readmission after lung cancer
    • resection is associated with a 6-fold increase in 90-day postoperative mortality. J Thorac
    • Cardiovasc Surg. 2014 Nov;148(5):2261-2267.e1. doi: 10.1016/j.jtcvs.2014.04.026. Epub
    • 2014 Apr 18. PubMed PMID: 24823283; PubMed Central PMCID: PMC4201876. 25. Avritscher EB, Cooksley CD, Rolston KV, Swint JM, Delclos GL, Franzini L, Swisher SG,
    • Care Cancer. 2014 Feb;22(2):527-35. doi: 10.1007/s00520-013-2006-1. Epub 2013 Oct
    • 19. PubMed PMID: 24141699. 26. Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, Tsai TC, Ko CY, Bilimoria
    • United States. JAMA. 2015 Feb 3;313(5):483-95. doi: 10.1001/jama.2014.18614.
    • PubMed PMID: 25647204. 27. Dimick JB, Ghaferi AA. Hospital readmission as a quality measure in surgery. JAMA. 2015
    • Feb 3;313(5):512-3. doi: 10.1001/jama.2014.14179. PubMed PMID: 25647207. 28. Horwitz LI, Lin Z, Herrin J, Bernheim S, Drye EE, Krumholz HM, Hines HJ Jr, Ross JS.
    • study. BMJ. 2015 Feb 9;350:h447. doi: 10.1136/bmj.h447. Erratum in: BMJ.
    • 2015;350:h895. Hines, Harold J Jr [added]. PubMed PMID: 25665806; PubMed Central
    • PMCID: PMC4353286. 29. Stitzenberg KB, Chang Y, Smith AB, Nielsen ME. Exploring the burden of inpatient
    • readmissions after major cancer surgery. J Clin Oncol. 2015 Feb 10;33(5):455-64. doi:
    • 0.1200/JCO.2014.55.5938. Epub 2014 Dec 29. PubMed PMID: 25547502; PubMed
    • Central PMCID: PMC4314594. 30. Puri V, Patel AP, Crabtree TD, Bell JM, Broderick SR, Kreisel D, Krupnick AS, Patterson GA,
    • Cardiovasc urg. 2015 Aug 28. pii: S0022-5223(15)01530-5. doi:
    • 10.1016/j.jtcvs.2015.08.067. [Epub ahead of print] PubMed PMID: 26410004. 31. Henneman D, Dikken JL, Putter H, Lemmens VE, Van der Geest LG, van Hillegersberg R,
    • should we go? Ann Surg Oncol. 2014 Dec;21(13):4068-74. doi: 10.1245/s10434-014-
    • 3873-5. Epub 2014 Jul 9. PubMed PMID: 25005073. 32. Piaggio G, Elbourne DR, Pocock SJ, Evans SJ, Altman DG; CONSORT Group. Reporting of
    • noninferiority and equivalence randomized trials: extension of the CONSORT 2010
    • statement. JAMA. 2012 Dec 26;308(24):2594-604. doi: 10.1001/jama.2012.87802.
    • PubMed PMID: 23268518. 33. Crawford SM, Sauerzapf V, Haynes R, Zhao H, Forman D, Jones AP. Social and
    • geographical factors affecting access to treatment of lung cancer. Br J Cancer. 2009 Sep
    • 15;101(6):897-901. doi: 10.1038/sj.bjc.6605257. Epub 2009 Aug 18. PubMed PMID:
    • 19690543; PubMed Central PMCID: PMC2743361. 34. Peake MD. Deprivation, distance and death in lung cancer. Thorax. 2015 Feb;70(2):108-
    • 9. doi: 10.1136/thoraxjnl-2014-206153. Epub 2014 Oct 13. PubMed PMID: 25311470.
  • No related research data.
  • No similar publications.

Share - Bookmark

Cite this article