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John D. Birkmeyer, Yating Sun, Aaron Goldfaden, Nancy J.O. Birkmeyer and Therese A. Stukel Volume and process of care in high-risk cancer surgery Cancer 106

Version of Record online: 21 APR 2006 | DOI: 10.1002/cncr.21888

While the relation between operative mortality and procedure volume is well established for high-risk cancer operations, differences in clinical practice between high-volume and low-volume centers are not well understood. The authors identified all patients who underwent major resections for lung, esophageal, gastric, liver or pancreatic cancer using the 2000-2002 Medicare claims database. They found that patients at high-volume hospitals were more likely to undergo preoperative stress tests and see medical or radiation oncologists, operations were significantly longer and patients were more likely to receive perioperative invasive monitoring (OR 2.56, 95%CI 1.82-3.60). Differences in measurable processes of care did not explain volume-related differences in operative mortality to any significant degree.

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