Published in:
01-09-2008 | Healthcare Policy and Outcomes
No Influence of Surgical Volume on Patients’ Health-Related Quality of Life After Esophageal Cancer Resection
Published in: Annals of Surgical Oncology | Issue 9/2008
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Background
Studies on factors that can counteract the negative impact of esophagectomy on patients’ health-related quality of life (HRQL) have been sparse. This study was undertaken to examine the question whether hospital or surgeon volume influences HRQL as evaluated 6 months after such surgery.
Materials and Methods
A Swedish prospective, population-based cohort study of esophageal cancer patients treated surgically in 2001–2005 was conducted. All patients completed validated HRQL questionnaires, developed by EORTC, addressing general HRQL (QLQ-C30) and esophageal-specific symptoms (QLQ-OES18), 6 months postoperatively. Mean scores with 95% confidence intervals were calculated. Clinically relevant mean score differences (≥10) between groups were further analyzed in a linear regression model, adjusted for several potential confounders.
Results
Some 355 patients were included (80% of eligible). No clinically relevant differences were found between low-volume (0–9 operations/year) and high-volume hospitals (>9 operations/year) or between low-volume (0–6 operations/year) and high-volume surgeons (>6 operations/year). Stratified analyses for tumor location did not reveal any differences between hospital or surgeon volume groups. Moreover, no material differences were found between the four individual high-volume hospitals.
Conclusion
This study revealed no HRQL advantages of being treated at high-volume hospitals or by high-volume surgeons, as measured 6 months after esophageal cancer resection.