ArticleAnnals of surgical oncology2019
Surgeon Volume and Surgeon Age in Relation to Proficiency Gain Curves for Prognosis Following Surgery for Esophageal Cancer.
Article in Annals of surgical oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Physician Age and Patient Outcomes: A Systematic Review.Journal of general internal medicine · 2026Pooled it
- Impact of overall major oncologic surgery volume on outcomes in esophagogastrectomies with intrathoracic anastomosis.Langenbeck's archives of surgery · 2025Article
- Association of Upper GI Surgery of Great Britain and Ireland (AUGIS) Delphi consensus recommendations on the adoption of robotic upper GI surgery.Annals of the Royal College of Surgeons of England · 2024Article
- A review of gynaecological surgical practices for trainees and certified specialists in Australia by volume using MBS and AIHW databases.The Australian & New Zealand journal of obstetrics & gynaecology · 2022Review
- Long-term effect of hospital volume on the postoperative prognosis of 158,618 patients with esophageal squamous cell carcinoma in China.Frontiers in oncology · 2022Article
- Hospital Surgical Volume and 3-Year Mortality in Severe Prognosis Cancers: A Population-Based Study Using Cancer Registry Data.Journal of epidemiology · 2021Article
- Current Issues in Minimally Invasive Esophagectomy.The Korean journal of thoracic and cardiovascular surgery · 2020Article
- Surgical and Surgeon-Related Factors Related to Long-Term Survival in Esophageal Cancer: A Review.Annals of surgical oncology · 2020Review
- Identifying an Eight-Gene Signature to Optimize Overall Survival Prediction of Esophageal Adenocarcinoma Using Bioinformatics Analysis of ceRNA Network.OncoTargets and therapy · 2020Article
- Learning curves in minimally invasive esophagectomy.World journal of gastroenterology · 2018Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurgery proficiency gain curves must be shortened to reduce patient harm during esophagectomy learning.
objectiveThis study aimed to test whether surgeon volume and surgeon age influenced the length of period of surgical proficiency gain.
methodsThis population-based cohort study included 1384 patients with esophageal cancer who underwent esophagectomy by any of the 36 highest-volume surgeons in Sweden between 1987 and 2010, with follow-up until 2016. Annual surgeon volume was dichotomized by the median values into 'higher-volume surgeons' (≥ 4 cases per year) and 'lower-volume surgeons' (< 4 cases per year), and surgeon age at the start of practicing esophagectomies into 'younger surgeons' (aged < 45 years) and 'older surgeons' (aged ≥ 45 years). Proficiency gain curves were constructed using risk-adjusted cumulative sum analysis for 1- to 5-year mortality (main outcome) and secondary outcomes (presented below). The results were adjusted for all established prognostic factors.
resultsFor 1- to 5-year mortality, the change point was at 14 cases among 'higher-volume surgeons', while 'lower-volume surgeons' had a later change point at 31 cases. The corresponding change points were at 13 cases among 'younger surgeons' and at 48 cases among 'older surgeons'. Similar patterns of differences in the proficiency gain curves were seen for the secondary outcomes of 30-day mortality and resection margin status (tumor involvement).
conclusionHigher-volume- and younger surgeons seem to have a substantially shorter period of proficiency gain for long-term mortality and other outcomes following surgery for esophageal cancer. This indicates a value of intensified training of younger surgeons for these complex operations.
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