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Urology Outcomes Better in High-Volume Hospitals

Outcome of surgery for urologic cancer is unrelated to specialty status of hospital

FRIDAY, May 5 (HealthDay News) -- Hospital-specific surgical outcomes for urologic cancer are related to the volume of urologic-specific procedures performed at the institution and not to their status as a specialized hospital or to how often they perform other procedures, according to a report in the May 1 issue of the Journal of Clinical Oncology.

Badrinath R. Konety, M.D., of the University of California San Francisco, and colleagues performed a cross-sectional analysis of outcome after radical cystectomy, radical nephrectomy and radical prostatectomy. Comparisons were made using procedure-specific volume, specialty hospital status and Leapfrog criteria that measured the volume of multiple procedures.

Neither specialty status nor Leapfrog volume criteria were associated with lower odds of in-house mortality. However, hospitals performing high volumes of radical cystectomy and moderate or high volumes of radical prostatectomy had lower mortality odds. For example, the risk of mortality for radical prostatectomy was lower (odds ratio, 0.22) in high-volume hospitals compared with low-volume hospitals. Radical nephrectomy outcome was unrelated to hospital factors.

"Generalized process measures existing in hospitals performing a high volume of general urologic procedures or unrelated complex procedures may be less important determinants of procedure-specific outcomes in patients," the authors conclude.

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