title: The influence of surgical volume on morbidity and mortality of radical hysterectomy for cervical cancer.
abstract: OBJECTIVE
  We examined the influence of physician and hospital volume on the morbidity and mortality of radical hysterectomy for cervical cancer.
  
  
  METHODS
  Women who underwent radical hysterectomy for cervical cancer between 2003 and 2007 were examined. The effect of surgeon and hospital volume on morbidity and mortality was examined using multivariable generalized estimating equations.
  
  
  RESULTS
  A total of 1536 women who underwent radical hysterectomy were identified. Patients treated by high-volume surgeons had fewer medical complications (odds ratio, 0.55; 95% confidence interval, 0.34-0.88) and shorter lengths of stay (odds ratio, 0.49; 95% confidence interval, 0.25-0.98). After adjustment for case mix and surgeon volume, hospital volume had no independent effect on any of the variables of interest.
  
  
  CONCLUSIONS
  High-volume surgeons have fewer postoperative medical complications, shorter lengths of stay, and lower transfusion requirements. Hospital volume appears to have only a minor influence on outcomes after radical hysterectomy.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Wright
authors.forename: Sharyn N
authors.initials: SN
authors.lastname: Lewin
authors.forename: Israel
authors.initials: I
authors.lastname: Deutsch
authors.forename: William M
authors.initials: WM
authors.lastname: Burke
authors.forename: Xuming
authors.initials: X
authors.lastname: Sun
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Herzog
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016526:Workload