Relationship between surgical volumes and 30-day mortality in patients with oesophagus and stomach cancer: a review of the literature and metanalysis

OBJECTIVES: to analyse the relationship between annual hospital volumes of surgery for oesophageal and gastric cancer and 30-day mortality. DESIGN: a systematic review of the literature has been carried out on these topics by searching Medline for the years 1998-2012 and using two ad hoc search strings. For oesophageal cancer, the most recent and best quality systematic review was updated by including further studies, and then a metanalysis was carried out. For gastric cancer, two different metanalyses on low and high volumes were performed. RESULTS: regarding oesophageal carcinoma, the study confirmed the association between 30-day mortality and the number of annual hospital interventions for this pathology. As for stomach cancer, the two metanalyses confirmed the role of high-volume surgery in reducing the outcome considered. CONCLUSIONS: this study confirms the association between short-term outcomes and the number of annual hospital interventions for oesophageal and gastric cancer. The results obtained may be important for health care policy makers and administrators/managers in order to improve quality of care for patients with oesophageal or stomach cancer.