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April 21, 1999

Influence of Hospital Volume on Mortality Following Major Cancer Surgery—Reply

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(15):1374. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-15-jbk0421

In Reply: Although Drs Schwarz and Ellenhorn report excellent results from the City of Hope, they may have misunderstood our definition of volume, which represents the total number of procedures with the designated International Classification of Diseases, Ninth Revision codes in the 10-year period of the study that were performed in elderly patients. If the relative frequencies of the types of procedure and age groupings in their census of 50 cancer pancreatectomies are similar to what we observed in the SEER-Medicare database, then City of Hope would be classified as a high-volume center.

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