ArticleSurgical endoscopy2026
Impact of hospital volume on outcomes of esophagectomy for esophageal cancer: analysis of a prospective multicenter database.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The efficacy of peroral endoscopic myotomy (POEM) for type III achalasia: a systematic review and meta-analysis.Surgical endoscopy · 2026Pooled it
- Global research trends in robotic surgery for rectal cancer: a bibliometric and science-mapping analysis.Journal of robotic surgery · 2026Review
- Characteristics of thoracoscopic anatomical lesion resection in the treatment of intralobar sequestration and congenital pulmonary airway malformation.Surgical endoscopy · 2026Article
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29 authors.
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Abstract
backgroundEsophageal cancer is a significant health burden in China, commonly treated by esophagectomy, a procedure with considerable risks. While higher hospital volume is associated with improved outcomes in Western countries, it remains unclear if this volume-outcome relationship persists in China, where many centers handle a relatively high caseload compared to Western standards. This study investigated the impact of hospital volume on perioperative morbidity and long-term survival outcomes following esophagectomy for esophageal cancer within the context of Chinese medical centers.
methodsThis study analyzed data from a prospective multicenter database (April 2015-December 2018) including 6775 patients with clinical stage cT1b-3N0-1M0 esophageal cancer undergoing radical esophagectomy across 19 Chinese centers. Centers were categorized based on procedural volume over 3.5 years: Group A (high-volume: ≥ 400 cases) and Group B (low-volume: < 400 cases). Perioperative complications and 5-year overall survival (OS) and disease-free survival (DFS) were compared. Propensity score matching (PSM) was employed to balance baseline characteristics between groups.
resultsAnalysis included 6,125 patients (4,633 Group A, 1,492 Group B) for survival outcomes. Group B demonstrated significantly higher rates of total complications (23% vs 19%, P < 0.001), including anastomotic leakage (5.9% vs 4.5%, P = 0.014), cardiovascular events (2.0% vs 0.9%, P < 0.001), and recurrent laryngeal nerve paralysis (12.1% vs 10.0%, P = 0.033), alongside longer mean operation times (P < 0.001). After PSM (1,492 matched pairs), Group A maintained superior 5-year OS (49% vs 45%, P < 0.05, HR: 1.12, 95%CI, 1.01-1.23) and 5-year DFS (45% vs 42%, P < 0.05, HR: 1.14, 95%CI, 1.03-1.25) compared to Group B.
conclusionsHospital volume significantly influenced esophagectomy outcomes in China, even among centers with relatively high caseloads. Treatment at high-volume centers was associated with lower postoperative morbidity and better long-term survival for patients with esophageal cancer.
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