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Where you have your cancer operation strongly affects whether you survive it. Publishing each hospital's adjusted results would push complex surgery towards the centres that do it well.
National mandatory reporting of risk-adjusted 90-day mortality, major complications, margin status, lymph node yield and volume for the most complex cancer operations (oesophagectomy, pancreatectomy, gastrectomy, cystectomy, hepatectomy, lung resection), published by hospital and, for high-volume procedures, by surgeon, with minimum volume thresholds for commissioning. The volume-outcome relationship in complex cancer surgery is among the most robust findings in health services research; the Netherlands, Denmark and parts of England have centralised and improved mortality. Public reporting plus commissioning thresholds is a policy lever that requires no new science and little money.
Shares A video-based surgical quality registry linking assessed skill to cancer outcomes, Mandatory staged registries for new surgical techniques before wide adoption, Surgery and radiotherapy cure most, get least.
Shares Fragmented care and guideline gaps, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
Shares Netherlands Cancer Institute (NKI-AvL), Surgery and radiotherapy cure most, get least, Fragmented care and guideline gaps.
Shares Fragmented care and guideline gaps, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.
Shares Surgery and radiotherapy cure most, get least, Fragmented care and guideline gaps, Oesophageal cancer, Bladder & urothelial cancer.
Shares Surgery and radiotherapy cure most, get least, Gastric & gastro-oesophageal junction cancer.
Shares Mandatory staged registries for new surgical techniques before wide adoption, Surgery and radiotherapy cure most, get least.
Shares Surgery and radiotherapy cure most, get least, Oesophageal cancer, Gastric & gastro-oesophageal junction cancer, Pancreatic ductal adenocarcinoma.