Cancer outcome good at regular high-volume centers

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In the long run, survival after cancer surgery appears to differ little at hospitals designated by the National Cancer Institute (NCI) as “centers of excellence” compared with other high-volume hospitals, according to a new report.

These results “suggest that NCI cancer center designation should be weighted less heavily than other factors in a patient’s deciding where to undergo major cancer surgery,” Dr. Nancy Birkmeyer and her colleagues conclude.

Birkmeyer, at the University of Michigan Medical School in Ann Arbor, and her team compared surgical mortality and long-term survival rates among patients undergoing one of six cancer-related surgeries at 51 NCI cancer centers and at 51 other high-volume hospitals.

Their study, in the journal Cancer, compared some 27,000 Medicare patients ages 65 to 99 years treated at an NCI center and about 36,800 who went to other hospitals.

Surgery mortality rates were somewhat lower at NCI centers for four procedures—resection of the colon, lung, stomach and esophagus. There was no difference for removal of the bladder or pancreas.

In contrast, the team found that the probability of surviving for five years did not differ much whether performed at an NCI cancer center or other high-volume hospital, for any of the six procedures.

People with cancer can optimize their odds of getting through surgery by selecting high-volume hospitals and high-volume surgeons with subspecialty training, Birkmeyer’s group advises.

SOURCE: Cancer, February 1, 2005.

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