Is centralization needed for esophago-gastric cancer patients with low operative risk? a nationwide study

Background

Centralization has been shown to improve POM in esophageal and, to a lesser extent, gastric cancer surgery; however, the benefit of centralization for patients with low operative risk is questionable. The aim of the study was to investigate the impact of center volume on postoperative mortality (POM) according to patient condition.

Methods

All consecutive patients who underwent esophago-gastric cancer surgery between 2010 and 2012 in France were included (n = 11,196). The 30-day POM was compared in terms of the center volume (low: 

Results

Low-volume centers treated 64.2% of patients. A linear decrease in 30-day and 90-day POM was observed with increasing center volume, with rates of 5.7% and 10.2%, 4.3% and 7.9%, 3.3% and 6.7%, and 1.7% and 3.6% in low-, intermediate-, high- and very high-volume centers, respectively (P 

Conclusions

To improve POM, esophago-gastric cancer surgery should be centralized, irrespective of the patient's condition or tumor location.

Clinical trial identification

Legal entity responsible for the study

CHRU Lille

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.