Surgery News - October 2008 - (Page 12)

S U R G E R Y NEWS • O C T O B E R 2 0 0 8 NEWS ore cancer deaths could be avoided by focusing national quality initiatives on factors affecting long-term survival, according to a study comparing patient mortality in the days and weeks following cancer operations with 5-year survival outcomes. The study, published in the August 1 issue of the Journal of Clinical Oncology, was conducted by researchers from the National Cancer Data Base (NCDB) of the American College of Surgeons. “We were surprised by the number of deaths that could be avoided long term if care at lower-volume hospitals could be improved,” reported lead author Karl Y. Bilimoria, M.D., a general surgery resident at Northwestern University’s department of surgery in Chicago and a former ACS research fellow. He and his colleagues compared these outcomes in the highest-volume hospitals with those in the lowest-volume hospitals across the country. This study is “not just another article on cancer surgery and patient outcomes,” Nicholas J. Petrilli, M.D., wrote in the commentary accompanying the article. “Dr. Bilimoria and associates look at this issue from a different perspective. [Their] objective was to determine whether differences in hospital surgical volume have a larger ef- FROM THE COLLEGE chemotherapy and other treatments as necessary, and aggressively follow patients for recurrences. We may also encourage some patients to participate in clinical trials.” Quality measures already developed for treatment of pancreatic cancer and melanomas will soon be attached to practical guidelines for low-volume hospitals to follow, Dr. Bilimoria said. “Most patients in the U.S. undergo cancer resection at low-volume hospitals. Moving all patients to high-volume centers is an impractical policy initiative at the national level. Rather, we would like to find what those highest-volume hospitals do to get their better outcomes and transfer those treatment strategies to the lowest-volume hospitals.” His co-investigators were David J. Bentrem, M.D., FACS; Mark S. Talamonti, M.D., FACS; James S. Tomlinson, M.D.; Andrew K. Stewart, M.A.; David P. Winchester, M.D., FACS, Medical Director, Cancer Programs, ACS Division of Research and Optimal Patient Care; and Clifford Y. Ko, M.D., M.S., MSHS, FACS, Director, ACS Division of Research and Optimal Patient Care. The study was supported by the ACS Clinical Scholars in Residence program and Feinberg School of Medicine at Northwestern University. ■ NCDB Study Shows Usefulness of Quality Measures M hospitals had significantly lower morfect on perioperative mortality or on tality rates than those treated at the long-term survival.” lowest-volume centers. Likewise, over The study team monitored 243,103 a 5-year period, patients NCDB records for patients treated at the highest-volwho had surgery for nonume centers had significantmetastatic colon, ly higher survival rates than esophageal, gastric, liver, those treated at lowest-vollung, pancreatic, or rectal ume centers. For the seven cancer from 1994 through cancer sites combined, the 1999. They compared surtotal number of potentially vival during the perioperaavoidable deaths in the U.S. tive period within 60 days of each year was 2,207 during death and 5-year survival, excluding perioperative We were surprised the 60-day perioperative period and 7,245 for long-term deaths. “First, we compared by the number of survival under these adjustthe magnitude of the reladeaths that could ed circumstances. “We tive differences between be avoided at found that the magnitude of hospitals in both time lower-volume the risk of dying is greater frames, perioperative and hospitals. early on, but the number of long term. Second, we calDR. BILIMORIA lives affected long term is culated the number of poconsiderably greater,” he said. tentially avoidable deaths if outcomes “Our results indicate that quality inicould be improved at lower-volume tiatives should move beyond measuring hospitals to those seen at highest-volfactors affecting perioperative outume hospitals,” Dr. Bilimoria said. comes,” he noted. Dr. Bilimoria beThe researchers discovered that hoslieves the key is to improve the quality pital surgical volume was a factor for both time periods studied for all cancer of surgical treatment at all hospitals to potentially affect long-term outcomes: sites except for liver resection surgery, where no survival rate differences were “We can achieve this goal by making sure we remove all of the cancer, take noted. Outcomes during the 60-day perioperative period showed that over- out the right number of lymph nodes, give all appropriate individuals all, patients treated at highest-volume CoC Announces Paper Competition Winners T hree winners of the 2008 Commission on Cancer (CoC) Paper Competition have been selected from among 80 abstracts that were submitted describing cancer care in basic laboratory research, clinical investigation, or quality of care/health services research. Reviewed by members of the CoC’s Committee on Cancer Liaison, the abstracts were scored on the basis of originality, scientific merit, research quality, relevance, and importance. Selecting the winners was not easy; all papers showed promise and progress in the fight against cancer. The first-place winner was Jocelyn Logan-Collins, M.D., University of Cincinnati (Ohio) College of Medicine, for Silencing of the RON Tyrosine Kinase Receptor Results in Decreased Cell Survival and Increased Sensitivity to Gemcitabine in vivo. She received a $1,000 award and was invited to speak at the CoC meeting on Sunday, Oct. 12, during the Clinical Congress. The second- and third-place winners received a $500 award and were asked to present their work at the Cancer Liaison physician breakfast on Monday, Oct. 13. Second place went to Karl Y. Bilimoria, M.D., M.S., Evanston Northwestern Healthcare, Evanston, Ill., for Sentinel Lymph Node Biopsy Alone vs. Completion Axillary Lymph Node Dissection for Node-Positive Breast Cancer. Third place went to J. Robert Newman, M.D., University of Alabama at Birmingham, for Blocking Anti-CD147 Antibody Suppresses Growth of Head and Neck Cancer Xenografts and Sensitizes Tumors to Radiation Therapy. The competition was open to U.S. general surgery residents, surgical specialty residents, subspecialty residents, and oncology fellows. It is funded by the CoC and a memorial gift from Mrs. A. Lee Campione, in honor of her late husband, Matthew P. Campione, M.D., FACS. Individuals who submitted an abstract and were not selected have been encouraged to work with their CoC state chair and chapters of the ACS to explore opportunities to present their work at an upcoming meeting. The call for abstracts for the 2009 CoC Paper Competition will be issued in November. ■ Revamped Web Site Steers Users To Volunteerism Resources restructured Operation Giving Back Web site makes it easier for surgeons interested in volunteerism to find the resources and information they seek. On the OGB homepage, located at www.operationgivingback.org, is a menu tab entitled Resource Centers. Click on this tab for links to information organized by subject matter and relevance to different groups. For instance, under Resources for Surgeons in Practice, you’ll find general information useful to all actively practicing surgeons exploring volunteerism, as well as information specific to the needs of military and international surgeons. Resources for Surgeons in Training includes sections for surgical residents and medical students with links to programs that allow participation from surgeonsin-training and information on funding and education. Resources for retired surgeons contains information related to retiree licensure, liability, and other issues unique to these volunteers. Resources for the Surgical Team directs you to surgical safety and quality initiatives applicable to all volunteers and volunteerism programs instituted by surgical colleagues in the anesthesia, nursing, physician assistant, and surgical technologist communities. The new Resources by Specialty category has infor- mation related to your particular training and skills. There is also a new section called Resources for Volunteering in the U.S., and a separate section on disaster response. The newly organized Reading Room section offers links to scientific articles of interest on volunteerism, books, news stories, and articles in the Bulletin that have featured the humanitarian outreach activities of ACS members. Links to several dozen organizations that specialize in the exchange of medical equipment, supplies, or texts are provided under the heading Donations of Medical Goods. Although each volunteer opportunity listed in OGB includes a country-specific toolkit with information on the culture, customs, political climate, and other factors relevant to that opportunity, the Resource Center also contains links to these same travel resources in generic form, allowing you to search by country of interest. Contact OGB if you have suggestions for other resources that might enhance this section of the Web site. As a reminder, the site’s links and references are provided as a service to surgical volunteers and other interested parties; as such, the content and policy of any outside link do not necessarily reflect ACS policies. ■ http://www.operationgivingback.org

Table of Contents Feed for the Digital Edition of Surgery News - October 2008

Surgery News - October 2008 Contents Call to Action Issued to Support DVT, PE Prevention Protocol Changes May Increase Donor Organs CMS Targets 2011 for Switch to ICD-10 Opinion: Election 2008 The 20/20 Vision: Children's Health News From the College: Survival Strategy General Surgery: Innovations

Surgery News - October 2008

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