Differential Safety Between Top-Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery

Abstract

For many patients with cancer, complex surgery represents both their best chance of cure and their greatest potential for treatment-associated harm, as major complications remain common.^1-5 Previous studies have identified wide variation in the safety of complex surgical procedures for cancer across hospitals, with lethal complications occurring up to 4 times more often at low-volume or underperforming hospitals.^4,6-8 Unfortunately, nearly half of complex surgical procedures for cancer take place in these higher-risk hospital environments.^7,9 As a result, multiple attempts have been made by payers and clinicians to direct patients toward the safest hospitals for complex cancer surgery, with variable outcomes.^10-12 Ultimately, individual choice for hospital care may harbor the greatest potential to align patients with the safest environments for complex cancer surgery, but would require patients to be adequately informed of their safest options.