BMJ  2003;327 (12 July), doi:10.1136/bmj.327.7406.0

Lobectomy mortality is a poor measure of surgical performance

Mortality from lobectomy for primary lung cancer is a poor means of measuring surgeons' performance. Treasure and colleagues (p 73) analysed the mortality data for lung cancer surgery that thoracic surgeons are obliged to report for standards monitoring. Data from the Society of Cardiothoracic Surgeons of Great Britain and Ireland show a wide range of surgical volume, which reflects the widespread mixed practice of cardiothoracic surgery in the United Kingdom. They found no significant relation between in-hospital mortality and the number of operations performed by the surgeon. The data are not risk adjusted; the authors argue that the most likely effect of these data is to reduce the number of cancer operations by encouraging surgeons to avoid high risk cases.

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Assessment of whether in-hospital mortality for lobectomy is a useful standard for the quality of lung cancer surgery: retrospective study

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