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Outcomes for Complex GI Cancer Surgery Better at Top-Ranked Hospitals

MONDAY, March 29, 2021 -- For patients who require complex gastrointestinal (GI) cancer surgery, outcomes are improved when surgery is performed at top-ranked hospitals, according to a study published online March 19 in the Journal of the American College of Surgeons.

Erika Tay, M.D., from the University of California Irvine Medical Center in Orange, and colleagues examined outcomes using data from the Vizient database for patients who underwent esophagectomy, gastrectomy, and pancreatectomy for malignancy between January and December 2018. Perioperative outcomes were analyzed according to the U.S. News & World Report annual ranking status. Data were included for 3,054 complex GI cancer resections performed at 42 top-ranked hospitals and 3,608 resections performed at 198 nonranked hospitals.

The researchers found that the mean annual case volume was 73 and 18 cases at top-ranked and nonranked hospitals, respectively. Top-ranked hospitals had lower in-hospital mortality (0.96 versus 2.26 percent) and a lower mortality index (0.71 versus 1.53) compared with nonranked hospitals. There were no significant between-group differences observed in length of stay, rate of serious complications, or direct costs. Top-ranked hospitals had a lower mortality compared with nonranked hospitals among those who developed serious morbidity (8.2 versus 16.8 percent).

"Even younger, low-risk patients fare better when they go to a top-ranked hospital," a coauthor said in a statement. "So even if you are healthy, and you're dealing with a complex GI condition requiring surgical resection, you are probably better off also obtaining care at a top-ranked hospital."

Several authors disclosed financial ties to the medical device industry.

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