目的：最近，卵巢癌手术的目标已从最佳的细胞减灭术转变为更完整的切除。这项研究试图使用最新数据重新评估和更新手术病例量与卵巢癌手术后住院和长期死亡率之间的关系。
方法：本研究是一项基于人群的回顾性队列研究。参与者/材料：2005年至2019年在韩国接受卵巢癌手术的所有成年患者的数据均来自国家数据库。在此期间，共有362家医院的24,620名患者接受了卵巢癌手术。
方法：住院和1-，3-,将5年死亡率设定为主要和次要结局。
方法：医院分为大批量（>90例/年），中等容量（20-90例/年），和低容量（<20例/年）中心考虑病例量的总体分布。调整潜在危险因素后，使用logistic回归分析术后院内和长期死亡率。
结果：与高容量中心（0.54％）相比，中等容量的住院死亡率明显更高(1.40%；调整后的比值比，2.92；置信区间，1.82-3.73；p<0.001)和低交易量(1.61%；调整后的赔率比，2.94；置信区间，2.07-4.17；p<0.001）中心。此外,1年死亡率为6.26%,7.06%,大批量为7.94%，中等体积,和低容量中心，分别,组间差异显著。然而,卵巢癌术后3年和5年死亡率的病例体积效应不明显.
结论：在解释数据时，应考虑由于管理数据的性质而缺乏临床信息，例如分期或组织学诊断。
结论：对于卵巢癌手术后的院内死亡率和1年死亡率，而在3年或5年死亡率中没有明确发现。病例体积效应的稀释可能归因于护理的高度可及性。
OBJECTIVE: The goal of ovarian cancer surgery has recently shifted from optimal cytoreduction to more complete resection. This study attempted to reassess and update the association between surgical
case-volume and both in-hospital and long-term mortality after ovarian cancer surgery using recent data.
METHODS: This study is a population-based retrospective cohort study. Participants/Material: Data from all adult patients who underwent ovarian cancer surgery in Korea between 2005 and 2019 were obtained from the national database. A total of 24,620 patients underwent ovarian cancer surgery in 362 hospitals during the period.
METHODS: In-hospital and 1-, 3-, 5-year mortality were set as primary and secondary outcomes.
METHODS: Hospitals were categorized into high-volume (>90 cases/year), medium-volume (20-90 cases/year), and low-volume (<20 cases/year) centers considering overall distribution of
case-volume. Postoperative in-hospital and long-term mortality were analyzed using logistic regression after adjusting for potential risk factors.
RESULTS: Compared to high-volume centers (0.54%), in-hospital mortality was significantly higher in medium-volume (1.40%; adjusted odds ratio, 2.92; confidence interval, 1.82-3.73; p < 0.001) and low-volume (1.61%; adjusted odds ratio, 2.94; confidence interval, 2.07-4.17; p < 0.001) centers. In addition, 1-year mortality was 6.26%, 7.06%, and 7.94% for high-volume, medium-volume, and low-volume centers, respectively, and the differences among the groups were significant. However,
case-volume effect was not apparent in 3- and 5-year mortality after ovarian cancer surgery.
CONCLUSIONS: Lacking clinical information such as staging or histologic diagnosis due to the nature of the administrative data should be considered in interpreting the data.
CONCLUSIONS: Case-volume effect was observed for in-hospital and 1-year mortality after ovarian cancer surgery, while it was not clearly found in 3- or 5-year mortality. Dilution of the
case-volume effect might be attributed to the high accessibility to care.
