June 2003
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Tumor Cells in Blood May Indicate More Aggressive Breast Cancer

Cancer Patients Have Better Outcomes at Busier Hospitals

Patients who undergo surgery for rectal cancer at high-volume hospitals have better rates of survival and lower rates of permanent colostomy than patients who are operated on at low-volume hospitals, according to a study in the Journal of the National Cancer Institute.

Hospital volume (i.e., the number of operations performed at a hospital) has been associated with outcomes after surgery for cancers of the pancreas, esophagus, prostate, breast, lung, and colon. However, the association between hospital volume and outcomes after rectal cancer surgery has been less clear.

David C. Hodgson, M.D., of the Princess Margaret Hospital and the University of Toronto in Canada, John Z. Ayanian, M.D., of the Harvard Medical School in Boston, and their colleagues compared outcome measures among 7,257 patients who underwent surgery for rectal cancer.

Hodgson and his colleagues found that patients treated at low-volume hospitals (those performing fewer than 7 rectal cancer operations per year) had a higher postoperative mortality rate (4.8% versus 1.6%) and lower 2-year survival rate (76.6% versus 83.7%) than patients treated at high-volume hospitals (those performing more than 20 operations per year).

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