Rare cancer deaths worse 'in the wrong hospitals'

PATIENTS with rare cancers are twice as likely to die after surgery if they are sent to the ''wrong'' hospital, new research claims. It has prompted the state's peak cancer control agency to call for the consolidation of such surgeries into specialised units.

The research by the Cancer Institute NSW found some hospitals were undertaking too few of the complicated surgeries for staff to gain the experience to treat cancers of the oesophagus and pancreas.

The institute has not publicly identified the individual hospitals in the study but said about 25 of them were doing the surgeries. Over a four-year period, some hospitals performed less than one surgical procedure per year with the aim of curing either oesophagus or pancreatic cancer and there was a strong association between small numbers of procedures and poor survival.

The chief executive of the institute, David Currow, said clinicians experienced in the treatment of oesophagus and pancreatic cancers needed to work with health service planners to provide improved services across the state.

''For some cancers, including upper gastrointestinal cancers, the consolidation of high-risk oncology surgical procedures in specialised centres is the next logical next step,'' Professor Currow said. ''Change to the system will require courage and collaboration - but to not act on this information would be a tragedy. This is mortality at a systemic level that we now need to address.''

Operations for those cancers were often long, complicated and carried a high risk. It did not make a difference if patients were sent to public or private hospitals, Professor Currow said, with the outcome dependent on the experience of all staff involved in patient treatment including nurses and physiotherapists.

He emphasised the outcomes for more common cancers, such as breast and colon, were ''world-class'' across the state and the institute's findings applied only to the roughly 100 surgeries for oesophagus cancers and 130 surgeries for pancreatic cancer done across the state each year.

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