title: Surgery in high-volume hospitals not commission on cancer accreditation leads to increased cancer-specific survival for early-stage lung cancer.
abstract: BACKGROUND
  Quality of oncologic outcomes is of paramount importance in the care of patients with non-small cell lung cancer (NSCLC). We sought to evaluate the relationship of hospital volume for lobectomy on cancer-specific survival in NSCLC patients treated in California, as well as the influence of Commission on Cancer (CoC) accreditation.
  
  
  METHODS
  The California Cancer Registry was queried from 2004 to 2011 for cases of Stage I NSCLC and 8,345 patients were identified. Statistical analysis was used to determine prognostic factors for cancer-specific survival.
  
  
  RESULTS
  A total of 7,587 patients were treated surgically. CoC accreditation was not significant for cancer-specific survival, but treatment in high-volume centers was associated with longer survival when compared with low- and medium-volume centers (hazard ratio 1.77, 1.474 to 2.141 and hazard ratio 1.23, 1.058 to 1.438).
  
  
  CONCLUSIONS
  These data suggest that surgical treatment in high-volume hospitals is associated with longer cancer-specific survival for early-stage NSCLC, but that CoC accreditation is not.
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, UC Davis Medical Center, Sacramento, CA, USA; Heart Lung Vascular Center, David Grant Medical Center, Travis Air Force Base, CA, USA. Electronic address: Elizabeth.david@ucdmc.ucdavis.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: David
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, UC Davis Medical Center, Sacramento, CA, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Cooke
authors.affiliation: Department of Public Health Sciences, UC Davis Medical Center, Sacramento, CA, USA.
authors.forename: Yingjia
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Section of General Thoracic Surgery, Department of Surgery, UC Davis Medical Center, Sacramento, CA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Perry
authors.affiliation: Division of Surgical Oncology, Department of Surgery, UC Davis Medical Center, Sacramento, CA, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Canter
authors.affiliation: Department of Public Health Sciences, UC Davis Medical Center, Sacramento, CA, USA; Public Health Institute, Cancer Registry of Greater California, Sacramento, CA, USA.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Cress
mesh_terms: D000068:Accreditation; D000368:Aged; D002140:California; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D061847:Hospitals, High-Volume; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Cancer-specific survival; Commission on cancer accreditation; Lobectomy; Non–small cell lung cancer; Sublobar resection; Thoracic surgery