Volume-Outcome Relationship in Lung Cancer Resection Among Veterans and Non-Veterans

Strategic Insights -

Researchers have investigated the relationship between hospital surgical volume and postoperative outcomes for early-stage non-small cell lung cancer (NSCLC) in Veteran and non-Veteran populations in the United States. The study aimed to evaluate the association between hospital surgical volume and postoperative outcomes, adjusting for relevant patient-, tumor-, and treatment-related covariates. The research found that patients who underwent surgical resection at high-volume hospitals had similar risk-adjusted odds of postoperative outcomes compared to those treated at low-volume hospitals, except for a lower risk-adjusted odds of prolonged hospitalization and 90-d mortality among patients treated at high-volume Commission on Cancer (CoC)-accredited hospitals.

Key Takeaways:

  • Researchers conducted a retrospective cohort study of patients diagnosed with stage I NSCLC who underwent surgical resection in the Veterans Health Administration (VHA) from 2007-2019 and National Cancer Database (NCDB) from 2010-2019.
  • The study included 11,623 patients from the VHA and 125,213 patients from the NCDB, categorized into high-volume and low-volume hospitals based on their annual volume of lung cancer resections.
  • Patients treated at high-volume VHA hospitals had similar risk-adjusted odds of postoperative outcomes compared to those treated at low-volume VHA hospitals, except for a lower risk-adjusted odds of prolonged hospitalization and 90-d mortality among patients treated at high-volume Commission on Cancer (CoC)-accredited hospitals.
  • The study concluded that the VHA's integrated healthcare model and academic partnerships may help mitigate volume-related outcome differences following surgery for early-stage lung cancer.
  • Additional research is needed to further investigate the volume-outcome relationship in lung cancer resection.

Statistics:

  • 11,623 patients from the VHA and 125,213 patients from the NCDB were included in the study.
  • High-volume VHA hospitals treated 3,434 patients, while low-volume VHA hospitals treated 8,189 patients.
  • High-volume Commission on Cancer (CoC)-accredited hospitals treated 41,219 patients, while low-volume CoC-accredited hospitals treated 84,994 patients.
  • Patients who underwent surgical resection at high-volume VHA hospitals had similar risk-adjusted odds of prolonged hospitalization (aOR 0.876, 95% CI 0.741-1.034) and 30-d major complications (aOR 1.146, CI 0.969-1.357) compared to those treated at low-volume VHA hospitals.

Sources:

  • Association of Hospital Surgical Volume With Outcomes in Resected Stage I Non-Small Cell Lung Cancer. Journal of Surgical Research, 2025;315:709-721.
  • Washington University School of Medicine.
  • National Cancer Database (NCDB).
  • Veterans Health Administration (VHA).
  • Commission on Cancer (CoC).
  • NewsRx. Data on Veterans Health Reported by Researchers at Washington University School of Medicine (Association of Hospital Surgical Volume With Outcomes in Resected Stage I Non-Small Cell Lung Cancer). Cancer Weekly. November 4, 2025; p 65.