ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2020
Volume Pledge is Not Associated with Better Short-Term Outcomes After Lung Cancer Resection.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Promising Short-Term Outcomes of Pulmonary Resections from Low-Volume Centre in Tier II City in India.Indian journal of surgical oncology · 2025Article
- Failure to Rescue and Lung Resections for Lung Cancer: Measuring Quality from the Operation Room to the Intensive Care Unit.Cancers · 2025Review
- Variation in Hospital Mortality After Complex Cancer Surgery: Patient, Volume, Hospital or Social Determinants?Annals of surgical oncology · 2024Article
- Comparison of failure to rescue in younger versus elderly patients following lung cancer resection.JTCVS open · 2023Article
- Surgeon Quality and Patient Survival After Resection for Non-Small-Cell Lung Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Minimum surgical volume to ensure 5-year survival probability for six cancer sites in Japan.Cancer medicine · 2023Article
- Assessment of short readmissions following elective pulmonary lobectomy.American journal of surgery · 2023Article
- Social determinants of health and lung cancer surgery: a qualitative study.Frontiers in public health · 2023Article
- [Risk-adjusted mortality rates outperform volume as a quality proxy in surgical oncology: a new perspective on hospital centralization using national population-based data].Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Quality versus quantity in surgical oncology - what is the future?Nature reviews. Clinical oncology · 2022Article
- Keeping a Safe Distance From Surgical Volume Standards.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Article
- Institutional-Level Differences in Quality and Outcomes of Lung Cancer Resections in the United States.Chest · 2021Article
- Volume-Based Care Regionalization: Pitfalls and Challenges.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Article
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Authors and funding
8 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe examined the relationship between short-term outcomes and hospitals and surgeons who met minimum volume thresholds for lung cancer resection based on definitions provided by the Volume Pledge. A secondary aim was to evaluate the volume-outcome relationship to determine alternative thresholds in the event the Volume Pledge was not associated with outcomes. PATIENTS AND
methodsWe conducted a retrospective study (2015-2017) using the Society of Thoracic Surgeons General Thoracic Surgery Database. We used generalized estimating equations that accounted for confounding and clustering to compare outcomes across hospitals and surgeons who did and did not meet the Volume Pledge criteria: ≥ 40 patients per year for hospitals and ≥ 20 patients per year for surgeons. Our secondary aim was to model volume by using restricted cubic splines to determine the association between volume and short-term outcomes.
resultsAmong 32,183 patients, 465 surgeons, and 209 hospitals, 16,630 patients (52%) received care from both a hospital and surgeon meeting the Volume Pledge criteria. After adjustment, there was no relationship with operative mortality, complications, major morbidity, a major morbidity-mortality composite end point, or failure to rescue. The Volume Pledge group had a 0.5 day (95% CI, 0.2 to 0.7 day) shorter length of stay. Our secondary aim revealed a nonlinear relationship between hospital volume and complications in which intermediate-volume hospitals had the highest risk of complications. Surgeon volume was associated with major morbidity, a major morbidity-mortality composite end point, and length of stay in an inverse linear fashion. Only 8% of surgeons had volumes associated with better outcomes.
conclusionThe Volume Pledge was not associated with better outcomes except for a marginally shorter length of stay. A re-examination of volume-outcome relationships for hospitals and surgeons yielded mixed results that did not reveal a practical alternative for volume-based quality improvement efforts.
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