Letters Volume-mortality for cystectomy

Centralisation of cancer services vindicated

BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c3336 (Published 22 June 2010) Cite this as: BMJ 2010;340:c3336
  1. Paul J Cathcart, academic clinical lecturer in urology1,
  2. Jan van der Meulen, professor of clinical epidemiology and director2,
  3. Mark Emberton, reader in interventional oncology and clinical director3,
  4. John Kelly, chair of uro-oncology and chair, NCRI Bladder Clinical Studies Group4
  1. 1University College London Hospital and Clinical Effectiveness Unit, Royal College of Surgeons of England, London WC2A 3PE
  2. 2Health Services Research Unit, London School of Hygiene and Tropical Medicine and Clinical Effectiveness Unit, Royal College of Surgeons of England, London WC2A 3PE
  3. 3Royal Free and University College London School of Medicine, University College London and Clinical Effectiveness Unit, Royal College of Surgeons of England, London WC1E 6AU
  4. 4University College London Hospital and Division of Surgery and Interventional Science, UCL Medical School, University College London, London WC1E 6AU
  1. pjcathcart{at}hotmail.com

    Mayer and colleagues evaluated the relation between volume and mortality for radical cystectomy in England.1 Their finding—that patients undergoing surgery in medium volume hospitals have a poorer outcome than those in low volume hospitals—contrasts with most published data.2 3

    A weakness of Mayer and colleagues’ study is …

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