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Call to consolidate rare surgeries

Complex surgery for rare cancers should be consolidated into specialised units to improve survival rates, the NSW peak cancer control agency has said.

Data from the Cancer Institute NSW has demonstrated an association between hospitals conducting very small numbers of procedures and poorer rates of survival.

Professor David Currow, Chief Cancer Officer and CEO of the Cancer Institute NSW said mortality rates doubled depending on the volume of surgeries performed by the hospital.

The data showed that over a four-year period some hospitals across NSW were performing less than one surgical procedure to cure either oesophagus or pancreas cancers per year. International data indicates a risk of higher mortality the fewer procedures a hospital performs.

Currow said the consolidation of high-risk oncology surgical procedures in specialised centres was the next logical step.

"There are hospitals across NSW that are simply performing too few of these complicated procedures. We need doctors, nurses and allied health practitioners working closely as a team, and doing enough procedures to ensure that everyone's skills are finely honed,” said Currow.

"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 system level that we now need to address,” he said.

While surgical outcomes for more common cancer surgeries, such as breast and colon, were world-class, Currow said a new approach was needed for rare cancers.

He said the experience of health teams had the largest impact on survival rates and centres should be performing at least six procedures a year to achieve optimal patient outcomes.

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