Improving Outcomes with Lung Cancer Surgery: Selective Referral or Quality Improvement?

Excerpt

The first evidence that procedure volume and other hospital attributes contribute to the outcomes of major surgery recently turned 50 years old.1 In cancer surgery, the relative importance of hospital factors varies widely according to which procedure and which outcome is being addressed.2 Nonetheless, a large body of literature documents the importance of hospital procedure volume as a determinant of both operative mortality and, more recently, late survival after a wide range of cancer procedures.3,4 Although this literature is less consistent, teaching hospitals may also have better outcomes for some procedures above and beyond that corresponding to their higher volumes. …