The Relationship Between Volume or Surgeon Specialty and Outcome in the Surgical Treatment of Lung Cancer: A Systematic Review and Meta-Analysis Erik.

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Presentation transcript:

The Relationship Between Volume or Surgeon Specialty and Outcome in the Surgical Treatment of Lung Cancer: A Systematic Review and Meta-Analysis Erik M. von Meyenfeldt, MD, Gea A. Gooiker, MD, Willem van Gijn, MD, Piet N. Post, PhD, Cornelis J.H. van de Velde, MD, PhD, Rob A.E.M. Tollenaar, MD, PhD, Houke M. Klomp, MD, PhD, Michel W.J.M. Wouters, MD Journal of Thoracic Oncology Volume 7, Issue 7, Pages 1170-1178 (July 2012) DOI: 10.1097/JTO.0b013e318257cc45 Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Selection process of reviewed studies. OR, odds ratio. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Forest plot of the included studies using OR in the meta-analysis on hospital volume and postoperative mortality for lung resections for cancer. Separate analysis of pneumonectomies and lobectomies in case of sufficient data. OR, odds ratio; Study name, name of first author (resection type if specific odds ratios available); Year, year of publication; Low, highest annual volume of low-volume category; High, lowest annual volume of high-volume category; CI, confidence interval. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Regression analysis of the effect of high procedural hospital volume on hospital mortality. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 4 Forest plot of the included studies in the meta-analysis on hospital volume and survival of lung resections for cancer. Study name, name first author (resection type if specific odds ratios available); Year, year of publication; Low, highest annual volume of low-volume category; High, lowest annual volume of high-volume category; CI, confidence interval. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 5 Forest plot of the included studies in the meta-analysis on surgeon volume and postoperative mortality of lung resections for cancer. Year, year of publication; Low, highest annual volume of low-volume category; High, lowest annual volume of high-volume category; CI, confidence interval. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 6 A and B, Forest plot of the included studies in the meta-analysis on surgeon specialty and postoperative mortality of lung resections for cancer. A, General surgeon versus general thoracic surgeon. B, General surgeon versus cardiothoracic surgeon. GS, general surgeon; TS, general thoracic surgeon; CTS, cardiothoracic surgeon; Year, year of publication; Low, highest volume of low-volume category; High, lowest annual volume of high -volume category; CI, confidence interval. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 7 Forest plot of the included studies in the meta-analysis on surgeon specialty and survival of lung resections for cancer. General surgeon versus general thoracic surgeon. GS, general surgeon; TS, general thoracic surgeon; Year, year of publication; Low, highest annual volume of low-volume category; High, lowest annual volume of high-volume category; CI, confidence interval. Journal of Thoracic Oncology 2012 7, 1170-1178DOI: (10.1097/JTO.0b013e318257cc45) Copyright © 2012 International Association for the Study of Lung Cancer Terms and Conditions