Cancer patients should check hospital's expertise before having surgery

November 24, 1998

New York, N.Y., November 23, 1998 -- There is increasing evidence that one of the first questions a cancer patient should ask his or her surgeon is, "How often do you perform this procedure?" That question should be followed up with, "How often is the procedure performed in this hospital?"

In a study published in the November 25 Journal of the American Medical Association, researchers from Memorial Sloan-Kettering Cancer Center found that mortality rates were 40 to 80% lower in hospitals that had the most experience performing a particular surgical procedure.

"Surgical management of a patient with cancer is learned and refined by practice and experience," said Dr. Murray Brennan, chairman of the Department of Surgery at Memorial Sloan-Kettering and a co-author of the paper. "The more experience the surgeon has in doing a specific procedure and managing patients with a specific cancer, the better the patient's chances that he or she will have a better outcome after the operation."

The researchers looked at outcomes for cancer patients age 65 years or older at diagnosis by analyzing the Surveillance, Epidemiology and End Results (SEER) Medicare linked database from 1984 to 1993. It consists of all cases of cancer in several defined geographic populations and encompasses 97% of all individuals 65 years of age or older. They chose five of the most difficult cancer operations including pancreatectomy, esophagectomy, pneumonectomy, hepatic resection, and pelvic exeneration. The researchers examined the database to identify a cohort of patients with the same type of cancer who were at the same stage of disease and had the same operation within two months of diagnosis. They then looked at the 30-day mortality rate for each procedure and compared the rates by hospital volume. In every instance, they found that hospitals with a high volume of surgery for selected procedures had a substantially lower surgical mortality rate than hospitals where the surgical team had limited experience with the procedures.

The results showed similar trends for each type of surgery. The relationship between outcome and volume was consistently demonstrated with mortality rates lower in the high volume hospitals. After 30 days, 12.9% of the patients who had a pancreatectomy performed in hospitals with a low volume died compared to 7.7% in hospitals with middle range of volume and 5.8% in a hospitals that had high volume. The results for esophagectomy were even more striking. The low volume hospitals had a 30-day mortality rate of 17.3% while the patient in high volume hospitals had only a 3.4% mortality rate.

"Our study provides evidence in support of a growing literature that specialist cancer care can significantly increase a patient's chance of survival," said Dr. Colin Begg, the study's first author, who is Chairman of the Department of Epidemiology and Biostatistics at Memorial Sloan-Kettering. "Patients who are potential candidates for complicated cancer operations should be made aware of these trends when selecting a hospital."

Memorial Sloan-Kettering Cancer Center is the world's oldest and largest private institution devoted to prevention, patient care, research, and education in cancer. Throughout its long distinguished history, the Center has played a leadership role in defining the standard of care for patients with cancer. In 1998, Memorial Sloan-Kettering was named the nation's best cancer care center for the sixth consecutive year by U.S. News & World Report.
MSKCC press releases can be found on line at:

Memorial Sloan Kettering Cancer Center

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to