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Kaplan-Meier Approach

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Related Experiment Videos

Outcome--more than just operative mortality.

Murray F Brennan1, Mark Radzyner, David M Rubin

  • 1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA. brennanm@mskcc.org

Journal of Surgical Oncology
|May 26, 2009
PubMed
Summary

Surgeon and hospital volume impact cancer surgery outcomes. Determining the specific volume thresholds needed for acceptable long-term cancer survival remains a key challenge for specialists.

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Area of Science:

  • Oncology
  • Surgical Outcomes
  • Health Services Research

Background:

  • Historical cancer surgery outcome reviews primarily focused on operative mortality.
  • Surgeon and institutional volume have been established as critical factors for perioperative outcomes.
  • Current research increasingly links long-term cancer survival to specialization, volume, payor, and institutional factors.

Purpose of the Study:

  • To review the evolution of outcome assessment in major cancer operations.
  • To highlight the shift from focusing solely on operative mortality to long-term survival.
  • To identify the challenge in determining sufficient volume thresholds for acceptable cancer outcomes.

Main Methods:

  • Literature review of historical and current studies on cancer surgery outcomes.
  • Analysis of factors influencing perioperative outcomes and long-term survival.
  • Identification of key variables including surgeon volume, institutional volume, specialization, and payor status.

Main Results:

  • Operative mortality was the primary historical measure of surgical success.
  • A strong correlation exists between surgeon/institutional volume and improved perioperative outcomes.
  • Long-term cancer survival is now recognized as being influenced by a complex interplay of factors.

Conclusions:

  • The focus in cancer surgery outcomes has broadened beyond immediate mortality.
  • Understanding the relationship between volume and long-term survival is crucial.
  • Further research is needed to define specific volume thresholds for optimal cancer patient outcomes.