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Can Smaller-Scale Comprehensive Cancer Centers Provide Outstanding Care in Abdominal and Thoracic Pediatric Solid Tumor Surgery? Results of a 14-Year Retrospective Single-Center Analysis

Joseph, J. ; Farron, A. ; Renella, R. ; Gapany, C.

In: Annals of Surgical Oncology, 2014, vol. 21, no. 5, p. 1726-1731

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    Titre
    • Can Smaller-Scale Comprehensive Cancer Centers Provide Outstanding Care in Abdominal and Thoracic Pediatric Solid Tumor Surgery? Results of a 14-Year Retrospective Single-Center Analysis
    Auteur
    • Joseph, J.. Division of Pediatric Surgery, Department of Pediatrics and Pediatric Surgery (DMCP), University Hospital of Lausanne, Lausanne, Switzerland
    • Farron, A.. Division of Pediatric Surgery, Department of Pediatrics and Pediatric Surgery (DMCP), University Hospital of Lausanne, Lausanne, Switzerland
    • Renella, R.. Division of Pediatric Surgery, Department of Pediatrics and Pediatric Surgery (DMCP), University Hospital of Lausanne, Lausanne, Switzerland
    • Gapany, C.. Department of Pediatrics and Pediatric Surgery, University Hospital of Geneva, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Annals of Surgical Oncology, 2014, vol. 21, no. 5, p. 1726-1731. Springer US; http://www.springer-ny.com
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:324819
    Summary
    Purpose: Quality of care and its measurement represent a considerable challenge for pediatric smaller-scale comprehensive cancer centers (pSSCC) providing surgical oncology services. It remains unclear whether center size and/or yearly case-flow numbers influence the quality of care, and therefore impact outcomes for this population of patients. Patients and Methods: We performed a 14-year, retrospective, single-center analysis, assessing adherence to treatment protocols and surgical adverse events as quality indicators in abdominal and thoracic pediatric solid tumor surgery. Results: Forty-eight patients, enrolled in a research-associated treatment protocol, underwent 51 cancer-oriented surgical procedures. All the protocols contain precise technical criteria, indications, and instructions for tumor surgery. Overall, compliance with such items was very high, with 997/1,035 items (95%) meeting protocol requirements. There was no surgical mortality. Twenty-one patients (43%) had one or more complications, for a total of 34 complications (66% of procedures). Overall, 85% of complications were grade 1 or 2 according to Clavien-Dindo classification requiring observation or minor medical treatment. Case-sample and outcome/effectiveness data were comparable to published series. Overall, our data suggest that even with the modest caseload of a pSSCC within a Swiss tertiary academic hospital, compliance with international standards can be very high, and the incidence of adverse events can be kept minimal. Conclusion: Open and objective data sharing, and discussion between pSSCCs, will ultimately benefit our patient populations. Our study is an initial step towards the enhancement of critical self-review and quality-of-care measurements in this setting.