title: The association of hospital volume with rectal cancer surgery outcomes.
abstract: OBJECTIVE
  An association between hospital volume and postoperative mortality has been identified for several oncologic surgical procedures. Our objective was to analyze differences in surgical outcomes for patients with rectal cancer according to hospital volume in the state of California.
  
  
  METHODS
  A cross-sectional study from 2000 to 2005 was performed using the state of California Office of Statewide Health Planning and Development database. Hospitals were categorized into low (≤30)-, medium (31-60)-, and high (>60)-volume groups based on the total number of rectal cancer operations performed during the study period.
  
  
  RESULTS
  Overall, 7,187 rectal cancer operations were performed. Of the 321 hospitals in the study cohort, 72 % (n = 232), 20 % (n = 65), and 8 % (n = 24) were low-, medium-, and high-volume hospitals, respectively. Postoperative mortality was significantly lower- in high-volume hospitals (0.9 %) when compared to medium- (1.1 %) and low-volume hospitals (2.1 %; p < 0.001). High-volume hospitals also performed more sphincter-preserving procedures (64 %) when compared to medium- (55 %) and low-volume hospitals (51 %; p < 0.001).
  
  
  CONCLUSIONS
  These data indicate that hospital volume correlates with improved outcomes in rectal cancer surgery. Rectal cancer patients may benefit from lower mortality and increased sphincter preservation in higher-volume centers.
authors: City of Hope National Medical Center, General and Oncologic Surgery, Duarte, CA, USA.
authors: Jeong-Heum
authors: JH
authors: Baek
authors: Abdulhadi
authors: A
authors: Alrubaie
authors: Eduardo A
authors: EA
authors: Guzman
authors: Sun Keun
authors: SK
authors: Choi
authors: Casandra
authors: C
authors: Anderson
authors: Steven
authors: S
authors: Mills
authors: Joseph
authors: J
authors: Carmichael
authors: Andy
authors: A
authors: Dagis
authors: Dajun
authors: D
authors: Qian
authors: Joseph
authors: J
authors: Kim
authors: Julio
authors: J
authors: Garcia-Aguilar
authors: Michael J
authors: MJ
authors: Stamos
authors: Lisa
authors: L
authors: Bening
authors: Alessio
authors: A
authors: Pigazzi
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D003710:Demography; D005260:Female; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data*; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome