Uterine cancer in Maryland: Impact of surgeon case volume and other prognostic factors on short-term mortality

Teresa P. Díaz-Montes, Marianna L. Zahurak, Robert L. Giuntoli, Ginger J. Gardner, Robert E. Bristow

Research output: Contribution to journalArticle

Abstract

Objectives.: To characterize the patterns of primary surgical care and short term outcomes for uterine cancer according to surgeon and hospital case volume. Methods.: A statewide hospital discharge database was used to identify women undergoing primary surgery for uterine cancer during 1994-2005. Surgeon case volume was categorized as low (≤ 99 cases/12 years), or high (≥ 100 cases/12 years). Hospital case volume was categorized as low (≤ 199 cases/12 years), or high (≥ 200 cases/12 years). Logistic regression models were used to evaluate for significant factors associated with in-hospital death and access to high volume care. Results.: Overall, 6,181 cases for uterine cancer were performed by 894 surgeons at 49 hospitals. Low volume surgeons performed 62.4% of the cases. Management by high volume surgeons was associated with a 53% reduction in the risk of the case being managed by different attending physician/surgeon (95%CI 0.38-0.57, p < 0.00). In contrast, 90.5% of cases were performed at high volume hospitals. Management by different attending physician/surgeon was associated with a 2.6 increase in the risk of in hospital death (95%CI 1.41-4.79, p = 0.00). Surgery performed by high-volume surgeons was associated with a 48% reduction in the risk of in-hospital death (95%CI 0.26-1.00, p = 0.05). Conclusions.: Surgical management of uterine cancer by high volume surgeons is associated with a decrease risk in in-hospital death. Increased efforts to concentrate the surgical management of uterine cancer by high volume surgeons at high volume centers should be undertaken.

Original languageEnglish (US)
Pages (from-to)1043-1047
Number of pages5
JournalGynecologic oncology
Volume103
Issue number3
DOIs
StatePublished - Dec 1 2006

Keywords

  • Access to care
  • Surgery
  • Uterine cancer

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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    Díaz-Montes, T. P., Zahurak, M. L., Giuntoli, R. L., Gardner, G. J., & Bristow, R. E. (2006). Uterine cancer in Maryland: Impact of surgeon case volume and other prognostic factors on short-term mortality. Gynecologic oncology, 103(3), 1043-1047. https://doi.org/10.1016/j.ygyno.2006.06.018