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Erschienen in:
01.06.2010 | Original Article
Surgical Outcomes Associated with Oesophagectomy in New South Wales: An Investigation of Hospital Volume
Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 6/2010
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Introduction
Resection 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.
Methods
All 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 Discussion
The 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.
Conclusion
Oesophagectomy in NSW is performed with satisfactory results. However, there is a suggestion that higher‐ rather than lower-volume hospitals have better post‐resection outcomes.