Do hospital facilities influence global cancer surgery outcomes?

Deo Suryanarayana & Prashant Gupta

The Lancet | Open Access | Published: May 24, 2022 | DOI:https://doi.org/10.1016/S2214-109X(22)00214-5

Cancer is emerging worldwide as a significant public health problem and trends indicate that low-income and middle-income countries (LMICs) are going to witness a substantial increase in cancer burden by 2040.¹ Surgery plays a vital role in the management of solid tumours, but only 25% of the global population has access to safe, affordable, and timely surgery.² This disparity is more pronounced in LMICs dealing with high cancer burden and limited resources. Timely access to quality multidisciplinary care is a critical factor determining outcomes. Surgical outcomes are reliant on the experience and skills of the surgeon, and the availability of ancillary support facilities. Cancer surgery outcomes have improved during the past three decades, primarily because of the advancements made in surgery, anaesthesia, surgical technology, perioperative, and critical care domains.^3  4 Operative mortality in patients receiving complex cancer surgeries such as Whipple’s resection and oesophagectomy has reduced drastically.⁵ However, most of these studies originate from tertiary care cancer centres in high-income countries, and there is little literature available related to cancer surgical outcomes from LMICs.

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