SynthesisAnnals of surgical oncology2026
The Impact of Hospital Volume on Postoperative Outcomes for Esophagectomy and Gastrectomy: A Systematic Review and Meta-analysis.
Synthesis in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- [Consequences from the reform of hospital structure for surgery: what does centralization offer university visceral surgery departments?]Chirurgie (Heidelberg, Germany) · 2026Review
- ASO Author Reflections: Centralizing Esophagogastric Cancer Surgery: Beyond Volume Thresholds.Annals of surgical oncology · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh-volume hospitals tend to have better outcomes in complex surgeries, but outcome variations and volume thresholds complicate conclusions. This systematic review/meta-analysis assessed the impact of hospital volume on postoperative outcomes after esophagogastric surgery and identified volume thresholds beyond which benefits plateau.
methodsPubMed/MEDLINE was searched for cohort studies (2013-2023) on volume and outcomes after esophagectomy/gastrectomy for cancer. Primary outcome was 30-day mortality. Secondary outcomes included 90-day mortality, complications, length of stay (LOS), and long-term survival. The meta-analysis compared hospital volumes using odds ratios (ORs) for binary outcomes, hazard ratios (HRs) for survival, and mean differences (MDs) for LOS. A generalized estimating equation model assessed the continuous association between volume and 30-day mortality. Segmented regression identified volume thresholds where outcomes plateaued.
resultsOf 2679 articles, 56 studies on hospital volume and outcomes after esophagectomy and gastrectomy for cancer were included. High-volume hospitals (4-239 resections/year) showed lower 30-day mortality (OR 0.51; 95% confidence interval [CI] 0.43-0.59), 90-day mortality (OR 0.65; 95% CI 0.56-0.74), fewer complications (OR 0.83; 95% CI 0.74-0.94), shorter LOS (MD -1.50 days; 95% CI 0.97-2.03), and better survival (HR 0.83; 95% CI 0.78-0.87). Each doubling of volume demonstrated a significant reduction in 30-day mortality for esophagectomy (OR/volume-doubling 0.74; 95% CI 0.68-0.81) and gastrectomy (OR/volume-doubling 0.70; 95% CI 0.61-0.82). Breakpoints were identified at 43 cases for esophagectomy and 15 cases for gastrectomy per year, beyond which the association plateaued.
conclusionsHigher hospital volume is associated with lower mortality, reduced complications, shorter LOS, and improved survival. Identified thresholds exceed existing policy benchmarks, supporting further centralization of esophagogastric cancer surgery.
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