Surgical outcomes associated with oesophagectomy in New South Wales: an investigation of hospital volume.
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.
P Stavrou
Efty
E
Cancer Institute NSW, Monitoring, Evaluation and Research Unit, PO Box 41, Alexandria, NSW 1435, Australia. efty.stavrou@unsw.edu.au
S Smith
Garett
G
Baker
Deborah F
DF
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