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Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis

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Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis. / Gottlieb-Vedi, Eivind; Mattsson, Fredrik; Lagergren, Pernilla; Lagergren, Jesper.

In: European Journal of Surgical Oncology, Vol. 45, No. 10, 01.10.2019, p. 1839-1846.

Research output: Contribution to journalArticle

Harvard

Gottlieb-Vedi, E, Mattsson, F, Lagergren, P & Lagergren, J 2019, 'Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis', European Journal of Surgical Oncology, vol. 45, no. 10, pp. 1839-1846. https://doi.org/10.1016/j.ejso.2019.03.016

APA

Gottlieb-Vedi, E., Mattsson, F., Lagergren, P., & Lagergren, J. (2019). Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis. European Journal of Surgical Oncology, 45(10), 1839-1846. https://doi.org/10.1016/j.ejso.2019.03.016

Vancouver

Gottlieb-Vedi E, Mattsson F, Lagergren P, Lagergren J. Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis. European Journal of Surgical Oncology. 2019 Oct 1;45(10):1839-1846. https://doi.org/10.1016/j.ejso.2019.03.016

Author

Gottlieb-Vedi, Eivind ; Mattsson, Fredrik ; Lagergren, Pernilla ; Lagergren, Jesper. / Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis. In: European Journal of Surgical Oncology. 2019 ; Vol. 45, No. 10. pp. 1839-1846.

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@article{0ed0b6cedf674f78a1ca00bc4d34d17c,
title = "Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis",
abstract = "Background: Studies examining hospital volume for surgery for various gastrointestinal (GI) cancer types have shown conflicting results regarding the influence on long-term prognosis. The aim of this study was to examine annual hospital volume in relation to long-term survival after elective surgery for all GI cancers (esophagus, stomach, liver, pancreas, bile ducts, small bowel, colon, and rectum). Methods: Population-based cohort study including all 45,908 patients who underwent elective surgery for GI cancers in Sweden in 2005–2013. Follow-up was until 2016 for disease-specific 5-year mortality (main outcome) and 2018 for all-cause 5-year mortality (secondary outcome). Hospitals were divided into quartiles for each GI cancer according to a 4-year average annual volume of the year of surgery and three years earlier. Multivariable Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for relevant confounders. Results: Higher hospital volume was associated with a survival benefit in the large group of patients (n = 26,688) who underwent colon cancer resection, with HR 0.89 (95% CI 0.84–0.96) for disease-specific 5-year mortality comparing the highest with the lowest quartile. Higher hospital volume improved 5-year mortality in sub-groups of patients who underwent surgery for cancer of the esophagus, pancreas, and rectum. No such improvements were found for cancer of the stomach, liver, bile ducts, or small bowel. Conclusion: Long-term survival was improved at higher volume hospitals for some GI cancers (colon, esophagus, pancreas, rectum), but not for others (stomach, liver, bile ducts, small bowel).",
keywords = "Mortality, Neoplasm, Operation, Resection, Survival",
author = "Eivind Gottlieb-Vedi and Fredrik Mattsson and Pernilla Lagergren and Jesper Lagergren",
year = "2019",
month = oct,
day = "1",
doi = "10.1016/j.ejso.2019.03.016",
language = "English",
volume = "45",
pages = "1839--1846",
journal = "European Journal of Surgical Oncology",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "10",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Annual hospital volume of surgery for gastrointestinal cancer in relation to prognosis

AU - Gottlieb-Vedi, Eivind

AU - Mattsson, Fredrik

AU - Lagergren, Pernilla

AU - Lagergren, Jesper

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background: Studies examining hospital volume for surgery for various gastrointestinal (GI) cancer types have shown conflicting results regarding the influence on long-term prognosis. The aim of this study was to examine annual hospital volume in relation to long-term survival after elective surgery for all GI cancers (esophagus, stomach, liver, pancreas, bile ducts, small bowel, colon, and rectum). Methods: Population-based cohort study including all 45,908 patients who underwent elective surgery for GI cancers in Sweden in 2005–2013. Follow-up was until 2016 for disease-specific 5-year mortality (main outcome) and 2018 for all-cause 5-year mortality (secondary outcome). Hospitals were divided into quartiles for each GI cancer according to a 4-year average annual volume of the year of surgery and three years earlier. Multivariable Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for relevant confounders. Results: Higher hospital volume was associated with a survival benefit in the large group of patients (n = 26,688) who underwent colon cancer resection, with HR 0.89 (95% CI 0.84–0.96) for disease-specific 5-year mortality comparing the highest with the lowest quartile. Higher hospital volume improved 5-year mortality in sub-groups of patients who underwent surgery for cancer of the esophagus, pancreas, and rectum. No such improvements were found for cancer of the stomach, liver, bile ducts, or small bowel. Conclusion: Long-term survival was improved at higher volume hospitals for some GI cancers (colon, esophagus, pancreas, rectum), but not for others (stomach, liver, bile ducts, small bowel).

AB - Background: Studies examining hospital volume for surgery for various gastrointestinal (GI) cancer types have shown conflicting results regarding the influence on long-term prognosis. The aim of this study was to examine annual hospital volume in relation to long-term survival after elective surgery for all GI cancers (esophagus, stomach, liver, pancreas, bile ducts, small bowel, colon, and rectum). Methods: Population-based cohort study including all 45,908 patients who underwent elective surgery for GI cancers in Sweden in 2005–2013. Follow-up was until 2016 for disease-specific 5-year mortality (main outcome) and 2018 for all-cause 5-year mortality (secondary outcome). Hospitals were divided into quartiles for each GI cancer according to a 4-year average annual volume of the year of surgery and three years earlier. Multivariable Cox regression provided hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for relevant confounders. Results: Higher hospital volume was associated with a survival benefit in the large group of patients (n = 26,688) who underwent colon cancer resection, with HR 0.89 (95% CI 0.84–0.96) for disease-specific 5-year mortality comparing the highest with the lowest quartile. Higher hospital volume improved 5-year mortality in sub-groups of patients who underwent surgery for cancer of the esophagus, pancreas, and rectum. No such improvements were found for cancer of the stomach, liver, bile ducts, or small bowel. Conclusion: Long-term survival was improved at higher volume hospitals for some GI cancers (colon, esophagus, pancreas, rectum), but not for others (stomach, liver, bile ducts, small bowel).

KW - Mortality

KW - Neoplasm

KW - Operation

KW - Resection

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85063079915&partnerID=8YFLogxK

U2 - 10.1016/j.ejso.2019.03.016

DO - 10.1016/j.ejso.2019.03.016

M3 - Article

AN - SCOPUS:85063079915

VL - 45

SP - 1839

EP - 1846

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 10

ER -

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