Improving outcomes after esophagectomy: the impact of operative volume.
Once considered an uncommon malignancy, primary esophageal adenocarcinoma has increased steadily in incidence over the past three decades. Despite advances in multimodality therapy, the prognosis for this tumor is generally poor. Surgical resection and reconstruction of the upper gastrointestinal tract is the current standard of care for localized esophageal cancer, but despite advances in perioperative care, still remains a relatively high-risk surgical procedure. Increasing numbers of reports published over the past decade have documented a clear volume-outcome relationship for several complex surgical procedures, and in particular for esophagectomy. The clinical implications of this association are reviewed in this section.
Casson
Alan G
AG
Department of Surgery, Division of Thoracic & Esophageal Surgery, Dalhousie University and the QE II Health Sciences Centre, 1278 Tower Road, Halifax, Nova Scotia, Canada B3H 2Y9. alan.casson@dal.ca
van Lanschot
J Jan B
JJ
D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D005544:Forecasting; D006801:Humans; D009017:Morbidity; D015996:Survival Rate; D016896:Treatment Outcome