title: Surgical outcomes associated with oesophagectomy in New South Wales: an investigation of hospital volume.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cancer Institute NSW, Monitoring, Evaluation and Research Unit, PO Box 41, Alexandria, NSW 1435, Australia. efty.stavrou@unsw.edu.au
authors.forename: Efty
authors.initials: E
authors.lastname: P Stavrou
authors.forename: Garett
authors.initials: G
authors.lastname: S Smith
authors.forename: Deborah F
authors.initials: DF
authors.lastname: Baker
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D016208:Databases, Factual; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D012042:Registries; D016019:Survival Analysis; D016896:Treatment Outcome