title: Specialty matters in the treatment of lung cancer.
abstract: The effect of surgeon volume, hospital volume, and surgeon specialty on operative outcomes has been reported in numerous studies. Short-term and long-term outcome comparisons for pulmonary resection for lung cancer have been performed between general surgeons (GS), cardiothoracic surgeons (CTS), and general thoracic surgeons (TS), using large administrative and inpatient databases. In the United States, general surgeons perform more pulmonary resection than thoracic surgeons. Studies have found that in cases involving thoracic surgeons, there is a lower operative mortality and morbidity, improved long-term survival, better adherence to established practice standards, and a lower cost compared with cases involving general surgeons. Some specific processes of care that account for these improved economic, operative, and oncological outcomes have been identified. Others are not yet specifically known and associated with specialization in thoracic surgery.
authors.affiliation: Division of Cardiothoracic Surgery, Oregon Health and Sciences University, Portland, Oregon 97239-3098, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Tieu
authors.forename: Paul
authors.initials: P
authors.lastname: Schipper
mesh_terms: D002983:Clinical Competence / Q000191:economics / Q000592:standards; D017046:Cost Savings; D013502:General Surgery / Q000191:economics / Q000592:standards; D019983:Guideline Adherence; D017048:Health Care Costs; D061847:Hospitals, High-Volume; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics / Q000401:mortality / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000592:standards; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care / Q000191:economics / Q000592:standards; D018570:Risk Assessment; D012307:Risk Factors; D013038:Specialization / Q000191:economics / Q000592:standards; D016019:Survival Analysis; D013903:Thoracic Surgery / Q000191:economics / Q000592:standards; D019616:Thoracic Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000401:mortality / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome