The influence of case load and the extent of resection on the quality of treatment outcome in gastric cancer

Aims: The background was to analyse the influence of hospital- and surgeon volume and of the extent of resective procedures on the quality of early and late treatment results in gastric cancer. Methods: The literature was reviewed by searching the databases of Medline, Cancerlit, Pubmed and the Cochran register. Results: The levels of evidence showed wide variations. The influence of hospital volume was more important for the outcome than the case load of the individual surgeon. The extent of surgical resection should be adapted to histology-or stage. The value of systematic lymph node dissection is stilt under discussion. Conclusions: We have found that the best treatment results were seen in high volume hospitals with experienced surgeons, even taking into account extended surgical procedures. Further studies are needed to define the optimal number of operations necessary to be carried out each year. (c) 2005 Elsevier Ltd. All rights reserved.