Cancer treatment and services: Surgical cancer treatment

About surgery

Surgery is the key treatment for many types of cancer. Surgery to remove a cancer is called a resection. It involves removing some or all of the tissue (or organ) where the cancer is located.

The best treatment for someone with cancer depends on many things, including the cancer type, how far it has spread (if at all), and the age and general health of the person.

Who should have surgery?

When surgery is the appropriate treatment of cancer, research shows the percentage of people who receive surgery for their cancer is different across geographic areas and population groups.[57–61]

Early access to surgery can improve outcomes for most cancers.[57,59–61]

It is important for people with cancer to have access to surgery if they are likely to benefit from it. However, it is also important to avoid unnecessary surgery for those who are not likely to benefit.

Where should surgery be performed?

Most cancer surgery in NSW is performed at larger hospitals. Some people may have to travel to another LHD to have surgery for their cancer.

The complexity and risks of cancer surgery are different for each person. They depend on the type of cancer (location in the body) and the different ways a resection can be performed.

Evidence shows people who need complex surgery for certain cancers (such as gastric, pancreatic and oesophageal cancers) are better to have it done at a hospital that performs these procedures more often.[57]

It is recommended that hospitals treating people with these cancer types should perform a certain number of resections each year. This is known as a ‘minimum suggested annual caseload’.

This section includes information on the proportion of resections at or above the minimum suggested annual caseload. Results for the most recent year are compared with the results from five years ago.

People having treatment for cancer, including surgery, should have their care overseen by a multidisciplinary cancer care team (MDT). The management of these cancers requires a team of health care professionals with suitable experience in providing appropriate care following surgery.

When should patients be discharged from hospital following surgery?

Length of hospital stay following surgery is one widely accepted indicator of health care quality across many jurisdictions.

Longer stays in hospital may indicate post-operative complications or availability of support services in hospital. Although the NSW ‘Hospital in the Home Program’ is available for some patients after discharge, it may be safer for a patient to remain in hospital for longer if they do not have access to appropriate support services at home. What is considered an extended length of hospital stay will vary between surgical procedures.

Jump to cancer types:

Overall key findings:

Between 2013 and 2018, the number of people who underwent a resection at a NSW public hospital that performed above the minimum suggested annual caseload increased for five cancer types:

  • Lung – increased by 3% to 93%
  • Rectal – increased by 6% to 85%
  • Gastric – increased by 21% to 86%
  • Oesophageal – increased by 7% to 86%
  • Pancreatic – increased by 8% to 90%.

The proportion of patients treated in higher volume centres also increased.

Note: Overall key findings only compare 2018 data to 2013 data and do not track the trend of resections above minimum caseload over the whole five years in between. The trend icons displayed in the annual caseload charts refer to the trend over the entire five‑year period, not just the two comparative years as is displayed in the overall key findings. This means there may be a discrepancy between increases/decreases reported, dependent on which method is used.


Resections as a proportion of estimated incidence, by cancer type, by local health district (LHD) of residence, NSW, 2011–2014 and 2015–2018*

Key findings:

  • The proportion of people having a resection (surgery) for cancer differs among cancer types.
  • When comparing the period 2011–2014 with 2015–2018, the NSW proportion of people having a resection increased for pancreatic cancer.
  • In 2019, the four new cancer types added to this chart were breast, colon, kidney and neurological.

Resections as a proportion of estimated incidence, by cancer type, by local health district (LHD) of residence, NSW, 2011–2014 and 2015–2018*

N= Number of people with a first admission for the specified cancer in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (APEDDR).

2. Resection rate is the proportion of people with a first admission for cancer who underwent a surgical resection.

3. The following LHDs with substantial interstate outflow were excluded: Northern NSW LHD, Southern NSW LHD, Murrumbidgee LHD (including Albury) and Far West LHD.

Lung cancer

Lung cancer causes more deaths than any other cancer in NSW and Australia. Survival from lung cancer is much lower than survival from most other cancers. A person’s likelihood of surviving lung cancer increases with earlier diagnosis.

The management of lung cancer can be complex. Treatment should be overseen by a team of health care professionals with experience in lung cancer, who can also provide appropriate care following treatment.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

NSW local health districts are working to align processes with the National Optimal Care Pathway for People with Lung Cancer.

Average annual flows of people for resection for lung cancer, by local health district (LHD) of residence, 2015–2018*

Key findings:

  • Half (50%) of people who had a resection for lung cancer had the surgery in their LHD of residence.
  • Lung cancer treatment is highly specialised therapy and requires surgery in higher volume centres with active multidisciplinary cancer care team participation. Travel outside of the local health district in where a person lives, may be appropriate to access these specialised services.

Average annual flows of people for resection for lung cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of lung cancer resections in 2015–2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for lung cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for lung cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Lung cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of lung cancer resections performed annually at NSW hospitals is 18.
  • In 2018, the proportion of lung cancer resections performed at NSW public hospitals that met the minimum annual caseload increased to 93%, compared with 90% in 2013.

Lung cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of lung cancer resections in 2018.

* Recommendation based on hospital-level distribution of lung cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that have performed lung cancer resections in 2013 or 2018 appear on this chart.

Lung cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of lung cancer resections performed in NSW private hospitals above the minimum suggested annual caseload increased to 92%, compared with 82% in 2012–13.

Lung cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of lung cancer resections in July 2017-June 2018.

* Recommendation based on hospital-level distribution of lung cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that have performed lung cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, lung cancer, 2015–2018

Key findings:

  • On average, 13% of patients in NSW public and 14% of patients in NSW private hospitals experience a stay greater than 14 days following surgery for lung cancer.
  • 13% of all patients undergoing surgery for lung cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 8% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, lung cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the Appendices.

3. All hospital and LHD level estimates are partially risk adjusted with variables adjusted for gender, age at admission, Charlson Comorbidity Index, American Society of Anesthesiologists (ASA) Physical Status Classification, urgency of procedure and extent of surgery where relevant. Refer to the appendices for further information regarding cancer specific risk adjustment criteria.

Adjusted surgical outcomes in NSW private hospitals, lung cancer, 2015–2018

Key findings:

  • On average, 13% of patients in NSW public and 14% of patients in NSW private hospitals experience a stay greater than 14 days following surgery for lung cancer.
  • 13% of all patients undergoing surgery for lung cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 8% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, lung cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the Appendices.

3. All hospital and LHD level estimates are partially risk adjusted with variables adjusted for gender, age at admission, Charlson Comorbidity Index, American Society of Anesthesiologists (ASA) Physical Status Classification, urgency of procedure and extent of surgery where relevant. Refer to the appendices for further information regarding cancer specific risk adjustment criteria.

Breast cancer

Breast cancer is a cancer that starts in any part of the breast. Treatment for breast cancer aims to remove the cancer and reduce the risk of it coming back.

Treatment can involve surgery, chemotherapy, targeted therapy, radiotherapy, hormone therapy, or a combination of these.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for breast cancer, by local health district (LHD) of residence, 2015–2018*

Key findings:

  • Breast cancer surgery was performed in all LHDs between 2015 and 2018.
  • 79% of people who had a resection for breast cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for breast cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of breast cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1 .Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for breast cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for breast cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Breast cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of breast cancer resections performed annually at NSW public hospitals is 36.
  • In 2018, the proportion of breast cancer resections performed in NSW public hospitals above the minimum suggested annual caseload remained consistent at 90%, compared with 92% in 2013.

Breast cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of breast cancer resections in 2018.

* Based on analysis of unplanned readmission in NSW data for breast cancer resections.

** In November 2013, Royal Prince Alfred Hospital cancer services began transitioning to Chris O'Brien Lifehouse.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed breast cancer resections in 2013 or 2018 appear on this chart.

Breast cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of breast cancer resections performed in NSW private hospitals above the minimum suggested annual caseload remained consistent at 94%, compared with 93% in 2012–13.

Breast cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of breast cancer resections in July 2017-June 2018.

* Based on analysis of unplanned readmission in NSW data for breast cancer resections.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed breast cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Proportion of breast cancer resections* with sentinel lymph node biopsy in NSW public hospitals, by hospital (ranked), 2013 and 2018

Key finding:

  • The number of breast cancer resections with sentinel lymph node biopsy in NSW public hospitals, increased by 4% to 75% in 2018, compared with 2013.

Proportion of breast cancer resections* with sentinel lymph node biopsy in NSW public hospitals, by hospital (ranked), 2013 and 2018

N= Number of breast cancer resections in 2018.

* Women undergoing a first resection for primary invasive breast cancer. The total number reported here is lower than the breast surgical volume report, because each woman is counted once regardless of the number of surgical resections.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 30 breast cancer resections in 2018 have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for 2018.

Proportion of breast cancer resections* with sentinel lymph node biopsy in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • The number of breast cancer resections with sentinel lymph node biopsy in NSW private hospitals, increased by 7% to 81% in 2017–18, compared with 2012–13.

Proportion of breast cancer resections* with sentinel lymph node biopsy in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of breast cancer resections in July 2017-June 2018.

* Women undergoing a first resection for primary invasive breast cancer. The total number reported here is lower than the breast surgical volume report, because each woman is counted once regardless of the number of surgical resections.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 30 breast cancer resections in July 2017-June 2018 have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for July 2017-June 2018.

Breast‑conserving surgery as a proportion of breast cancer resections* in NSW public hospitals, by hospital (ranked), 2013 and 2018

Key finding:

  • The number of breast‑conserving surgeries, as a proportion of breast cancer resections in NSW public hospitals, increased by 7% to 68% in 2018, compared with 2013.

Breast‑conserving surgery as a proportion of breast cancer resections* in NSW public hospitals, by hospital (ranked), 2013 and 2018

N= Number of breast cancer resections in 2018.

* Women undergoing a first resection for primary invasive breast cancer. The total number reported here is lower than the breast surgical volume report, because each woman is counted once regardless of the number of surgical resections.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 30 breast cancer resections have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for 2018.

4. Breast-conserving surgery: Surgery that involves removing the breast cancer and a small amount of healthy tissue around it.

Breast‑conserving surgery as a proportion of breast cancer resections* in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • The number of breast‑conserving surgeries, as a proportion of breast cancer resections in NSW private hospitals, increased by 9% to 73% in 2017–18, compared with 2012–13.

Breast‑conserving surgery as a proportion of breast cancer resections* in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of breast cancer resections in July 2017-June 2018.

* Women undergoing a first resection for primary invasive breast cancer. The total number reported here is lower than the breast surgical volume report, because each woman is counted once regardless of the number of surgical resections.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 30 breast cancer resections have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for July 2017-June 2018.

4. Breast-conserving surgery: Surgery that involves removing the breast cancer and a small amount of healthy tissue around it.

Proportion of mastectomies for invasive breast cancer with immediate breast reconstruction* in NSW public hospitals, by hospital (ranked), 2013 and 2018

Key finding:

  • The proportion of mastectomies performed with immediate breast reconstruction in NSW public hospitals increased by 7% to 18% in 2018, compared with 2013.

Proportion of mastectomies for invasive breast cancer with immediate breast reconstruction* in NSW public hospitals, by hospital (ranked), 2013 and 2018

N= Number of mastectomies in 2018.

* Reconstruction procedure in the same admission as mastectomy.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 20 breast cancer resections have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for 2018.

Proportion of mastectomies for invasive breast cancer with immediate breast reconstruction* in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • The proportion of mastectomies with immediate breast reconstruction in NSW private hospitals increased by 12% to 29% in 2017–18, compared with 2012–13.

Proportion of mastectomies for invasive breast cancer with immediate breast reconstruction* in NSW private hospitals, by hospital (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of mastectomies in July 2017-June 2018.

* Reconstruction procedure in the same admission as mastectomy.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Hospitals performing fewer than 20 breast cancer resections have been removed due to large variation in annual proportions.

3. Figures displayed in the graph are for July 2017-June 2018.

Breast cancer surgery and hypofractionation in NSW public and private hospitals, NSW, 2011–2014 and 2015–2018

Key findings:

  • Many factors need to be considered when looking at the quality of care for people having treatment for breast cancer. Indicators between 2015 and 2018 included the number of women having external beam radiotherapy using hypofractionation for early‑stage breast cancer, and those having the following types of procedure:
    • sentinel lymph node biopsy
    • breast-conserving surgery
    • reconstructive surgery in the same admission as their mastectomy.
  • There were differences in these measures between NSW LHDs.

Breast cancer surgery and hypofractionation in NSW public and private hospitals, NSW, 2011–2014 and 2015–2018

N¹= Number of breast cancer resections in NSW in 2015–2018.

N²= Number of mastectomies in NSW in 2015–2018.

N³= Number of early-stage breast cancer patients receiving external beam radiotherapy in NSW in 2015–2018.

* Private hospitals have been grouped by LHD boundaries.

** Early-stage breast cancer is defined as TNM Stage I or IIA. Refer to the 'Technical document' in the appendices for full definitions.

Private hospital figures are based on financial year reporting (July 2010 to June 2014, and July 2014 to June 2018).

Notes:

1. For further information regarding indicator data sources and definitions, refer to the individual surgery and hypofractionation charts and/or the 'Technical document' in the appendices.

Ovarian cancer

The management of ovarian cancer requires a team of health care professionals with experience in ovarian cancer treatment including surgery, who also provide appropriate care following treatment.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Specialist centres have been identified for treating gynaecological cancers in NSW, including ovarian cancer.

Specialist centres

There are eight public specialist gynaecological oncology centres in NSW:

  • Chris O’Brien Lifehouse, Sydney LHD
  • Hunter New England Centre for Gynaecological Cancer, (collaboration between John Hunter Hospital and The Calvary Mater Hospital Newcastle)—Hunter New England LHD
  • Liverpool Hospital, South Western Sydney LHD
  • Royal Hospital for Women, South Eastern Sydney
  • Royal North Shore Hospital, Northern Sydney LHD
  • St George Hospital, South Eastern Sydney LHD
  • Westmead Hospital, Western Sydney LHD
  • Sydney Adventist Hospital
Average annual flows of people for resection for ovarian cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 55% of NSW women had ovarian surgery in a specialist centre.

Average annual flows of people for resection for ovarian cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of ovarian cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for ovarian cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for ovarian cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Ovarian cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • In 2018, 55% of ovarian cancer resections in NSW public hospitals were carried out in hospitals identified as specialist gynaecological oncology centres.
  • A number of hospitals continue to operate on women with ovarian cancer, as planned procedures outside a specialist gynaecological oncology centre.

Ovarian cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of ovarian cancer resections in 2018.

** In November 2013, Royal Prince Alfred Hospital cancer services began transitioning to Chris O'Brien Lifehouse.

ᴧ Specialist gynaecological oncology centres.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed ovarian cancer resections in 2013 or 2018 appear on this chart.

Ovarian cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Ovarian cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of ovarian cancer resections in July 2017-June 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed ovarian cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, ovarian cancer, 2015–2018

Key findings:

  • On average, 8% of patients in NSW public and 7% of patients in NSW private hospitals experience an extended stay greater than 14 days following surgery for ovarian cancer.
  • 10% of all patients undergoing surgery for ovarian cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 5% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, ovarian cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, ovarian cancer, 2015–2018

Key findings:

  • On average, 8% of patients in NSW public and 7% of patients in NSW private hospitals experience an extended stay greater than 14 days following surgery for ovarian cancer.
  • 10% of all patients undergoing surgery for ovarian cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 5% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, ovarian cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Colon cancer

A colon cancer is a type of a bowel cancer, which is common in NSW.

Many people with colon cancer have surgery, and most can have it at a hospital close to home.

People having surgery for colon cancer should have their care overseen by a multidisciplinary cancer care team (MDT). The management of colon cancer requires a team of health care professionals with suitable experience in providing appropriate care before, during and after surgery.

Average annual flows of people for resection for colon cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 81% of people who had a resection for colon cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for colon cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of colon cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for colon cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for colon cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Colon cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of colon cancer resections performed annually in NSW hospitals is 12.
  • In 2018, the proportion of colon cancer resections performed in NSW public hospitals above the minimum suggested annual caseload remained consistent (at 96%), compared with 98% in 2013.

Colon cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of colon cancer resections in 2018.

* Recommendation based on hospital-level distribution of colon cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that have performed colon cancer resections in 2013 or 2018 appear on this chart.

Colon cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of colon cancer resections performed in NSW private hospitals above the minimum suggested annual caseload remained consistent (at 93%), compared with 91% in 2012–13.

Colon cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of colon cancer resections in July 2017-June 2018.

* Recommendation based on hospital-level distribution of colon cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed colon cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, colon cancer, 2015–2018

Key findings:

  • On average, 16% of patients in NSW public and 11% of patients in NSW private hospitals experience an extended stay greater than 14 days following surgery for colon cancer.
  • 13% of all patients undergoing surgery for colon cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 6% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, colon cancer, 2015–2018

Notes:

1.Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2.For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, colon cancer, 2015–2018

Key findings:

  • On average, 16% of patients in NSW public and 11% of patients in NSW private hospitals experience an extended stay greater than 14 days following surgery for colon cancer.
  • 13% of all patients undergoing surgery for colon cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 6% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, colon cancer, 2015–2018

Notes:

1.Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2.For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Rectal cancer

Rectal cancers are often grouped together with colon cancers, and this group of cancers is referred to as ‘bowel cancer’.

There has been rapid development in the diagnosis and treatment of rectal cancer in the past decade. Management of rectal cancer often includes more than a single treatment. Treatment modalities include surgery, chemotherapy and radiotherapy.

The management of these cancers is complex and requires a team of health care professionals with experience in rectal cancer treatment who also provide appropriate care following treatment.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Rectal nodes

Evidence shows a positive association between the number of lymph nodes examined and survival for people with rectal cancer.[62,63] To determine accurate cancer staging, clinical guidelines recommend collecting at least 12 associated pelvic lymph nodes during surgery for rectal cancer.[64]

Average annual flows of people for resection for rectal cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 73% of people who had a resection for rectal cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for rectal cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of rectal cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for rectal cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for rectal cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Rectal cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of rectal cancer resections performed annually in NSW hospitals is 12.
  • In 2018, the proportion of rectal cancer resections performed in NSW public hospitals above the minimum suggested annual caseload increased to 85%, compared with 79% in 2013.

Rectal cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of rectal cancer resections in 2018.

* Recommendation based on hospital-level distribution of rectal cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed rectal cancer resections in 2013 or 2018 appear on this chart.

Rectal cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of rectal cancer resections performed in NSW private hospitals above the minimum suggested annual caseload increased to 82%, compared with 76% in 2012–13.

Rectal cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of rectal cancer resections in July 2017-June 2018.

* Recommendation based on hospital-level distribution of rectal cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed rectal cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, rectal cancer, 2015–2018

Key findings:

  • On average, 18% of patients in NSW public and 9% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for rectal cancer.
  • 15% of all patients undergoing surgery for rectal cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 11% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, rectal cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, rectal cancer, 2015–2018

Key findings:

  • On average, 18% of patients in NSW public and 9% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for rectal cancer.
  • 15% of all patients undergoing surgery for rectal cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 11% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, rectal cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Number of nodes examined (excluding cases receiving neoadjuvant therapy*), rectal cancer, NSW, 2013–2016

Key finding:

  • 81% of NSW rectal cancer cases (excluding cases receiving neoadjuvant therapy) had greater or equal to 12 nodes examined.

Number of nodes examined (excluding cases receiving neoadjuvant therapy*), rectal cancer, NSW, 2013–2016

N=  Number of rectal cancer cases with nodes collected during and examined following primary resection.

*  Cases were excluded based on neoadjuvant therapy data available in the NSW Cancer Registry (NSWCR) as of August 2019. At this time the NSWCR was incomplete for treatment.

Notes:

1. Data source: NSW Cancer Registry (NSWCR).

2. The number of nodes examined were recorded from pathology reports of the primary rectal cancer resection, where present as a scanned image in the NSWCR. Cases were excluded where receipt of neoadjuvant therapy could be ascertained. The NSWCR may not have a record of primary resection if the pathology report was missing or resection was performed interstate (cross-border patients).

Proportion of cases with 15 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer surgery, by local health district (LHD) of residence**, NSW, 2013–2016

Key finding:

  • Between 2013 and 2016, the proportion of people with 12 or more lymph nodes examined during surgery for rectal cancer ranged from 43% to 91% across LHDs.

Proportion of cases with 15 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer surgery, by local health district (LHD) of residence**, NSW, 2013–2016

N= Number of rectal cancer cases with nodes collected during and examined following primary resection.

* Cases were excluded based on neoadjuvant therapy treatment data available in the NSW cancer Registry (NSWCR) as of August 2019. At this time the NSWCR was incomplete for treatment.

** LHD of residence relates to the address of residence at time of rectal cancer diagnosis.

Notes:

1. Data source: NSW Cancer Registry.

2. The number of nodes examined were recorded from pathology reports of the primary rectal cancer resection where present as a scanned image in the NSWCR. Cases were excluded where neoadjuvant therapy treatment could be ascertained. The NSWCR may not have a primary resection if the pathology report was missing or resections were performed interstate(cross-border patients).

Gastric cancer

Gastric cancer is a cancer of the stomach. Surgery for gastric cancer requires the right level of hospital capabilities and surgical expertise.

The management of this cancer requires a team of health care professionals with suitable experience, who also provide other therapies before and after surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Gastric nodes

Evidence suggests that retrieving 15 or more lymph nodes during gastric cancer surgery will improve the ability to accurately determine the cancer stage, and improve overall survival.[8,13,15]

Average annual flows of people for resection for gastric cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 64% of people who had a resection for gastric cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for gastric cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of gastric cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for gastric cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for gastric cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Gastric cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of gastric cancer resections performed annually in NSW hospitals is six.
  • In 2018, the proportion of gastric cancer resections performed in NSW public hospitals above the minimum suggested annual caseload increased (to 86%), compared with 65% in 2013.

Gastric cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of gastric cancer resections in 2018.

* Recommendation based on international studies and hospital-level distribution of gastrectomies in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed gastric cancer resections in 2013 or 2018 appear on this chart.

Gastric cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of gastric cancer resections performed in NSW private hospitals above the minimum suggested annual caseload increased (to 66%), compared with 58% in 2012–13.

Gastric cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of gastric cancer resections in July 2017-June 2018.

* Recommendation based on international studies and hospital-level distribution of gastrectomies in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed gastric cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, gastric cancer, 2015–2018

Key findings:

  • On average, 21% of patients in NSW public and 18% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for gastric cancer.
  • 15% of all patients undergoing surgery for gastric cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 10% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, gastric cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, gastric cancer, 2015–2018

Key findings:

  • On average, 21% of patients in NSW public and 18% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for gastric cancer.
  • 15% of all patients undergoing surgery for gastric cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 10% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, gastric cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Number of nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer, NSW, 2013-2016

Key finding:

  • Between 2013 and 2016, the proportion of people with 15 or more lymph nodes examined during surgery for rectal cancer was 65% in NSW.

Number of nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer, NSW, 2013-2016

N= Number of gastric cancer cases with nodes collected during and examined following primary resection.

*  Cases were excluded based on neoadjuvant therapy data available in the NSW Cancer Registry (NSWCR) as of August 2019. At this time the NSWCR was incomplete for treatment.

Notes:

1. Data source: NSW Cancer Registry (NSWCR).

2. The number of nodes examined were recorded from pathology reports of the primary gastric cancer resection, where present as a scanned image in the NSWCR. Cases were excluded where receipt of neoadjuvant therapy could be ascertained. The NSWCR may not have a record of primary resection if the pathology report was missing or resection was performed interstate (cross-border patients).

Proportion of cases with 12 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer surgery, by local health district (LHD) of residence**, NSW, 2013–2016

Key finding:

  • Between 2013 and 2016, the proportion of people with 15 or more lymph nodes examined during surgery for gastric cancer ranged from 25% to 100% across LHDs.

Proportion of cases with 12 or more lymph nodes examined (excluding cases receiving neoadjuvant therapy*), gastric cancer surgery, by local health district (LHD) of residence**, NSW, 2013–2016

N= Number of gastric cancer cases with nodes collected during and examined following primary resection.

*  Cases were excluded based on neoadjuvant therapy treatment data available in the NSW Cancer Registry (NSWCR) as of August 2019. At this time the NSWCR was incomplete for treatment.

**  LHD of residence relates to the address of residence at time of rectal cancer diagnosis.

Notes:

1. Data source: NSW Cancer Registry.

2. The number of nodes examined were recorded from pathology reports of the primary rectal cancer resection where present as a scanned image in the NSWCR. Cases were excluded where neoadjuvant therapy treatment could be ascertained. The NSWCR may not have a primary resection if the pathology report was missing or resections were performed interstate (cross-border patients).

Oesophageal cancer

The oesophagus is the tube that carries food from the back of the mouth down into the stomach. Surgery for an oesophageal cancer is very complex and can involve removing the oesophagus. This is called an oesophagectomy.

International research indicates that performing oesophagectomies at hospitals that do more of these surgeries contributes to improving outcomes.[65,66]

The management of an oesophageal cancer requires a team of health care professionals with suitable experience in providing appropriate care before and after surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for oesophageal cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 54% of people who had a resection for oesophageal cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for oesophageal cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of oesophageal cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for oesophageal cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for oesophageal cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Oesophageal cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of oesophageal cancer resections performed annually in NSW hospitals is six.
  • In 2018, the proportion of oesophageal cancer resections performed in NSW public hospitals above the minimum suggested annual caseload increased (to 86%), compared with 79% in 2013.

Oesophageal cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of oesophageal cancer resections in 2018.

* Recommendation based on international studies, analysis of NSW data, and hospital-level distribution of oesophagectomies in NSW.

Notes:

1.Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2.Only hospitals that performed oesophageal cancer resections in 2013 or 2018 appear on this chart.

Oesophageal cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of oesophageal cancer resections performed in NSW private hospitals above the minimum suggested annual caseload declined (to 71%), compared with 81% in 2012–13.

Oesophageal cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of oesophageal cancer resections in July 2017-June 2018.

* Recommendation based on international studies, analysis of NSW data, and hospital-level distribution of oesophagectomies in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed oesophageal cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, oesophageal cancer, 2015–2018

Key findings:

  • On average, 34% of patients in NSW public and 39% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for oesophageal cancer.
  • 22% of all patients undergoing surgery for oesophageal cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 9% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, oesophageal cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, oesophageal cancer, 2015–2018

Key findings:

  • On average, 34% of patients in NSW public and 39% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for oesophageal cancer.
  • 22% of all patients undergoing surgery for oesophageal cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 9% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, oesophageal cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Pancreatic cancer

The pancreas is a small organ at the back of the abdomen. Management of pancreatic cancer is complex and may require surgery to remove the pancreas. This procedure is called a pancreatectomy.

Pancreatectomies should be performed at a hospital with expertise in this surgery. The management of a pancreatic cancer requires a team of health care professionals with suitable experience in providing appropriate care before and after surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for pancreatic cancer, by local health district (LHD) of residence, 2015–2018*

Key findings:

  • A pancreatic cancer resection is a complex surgical procedure, which is mostly performed in LHDs with larger hospitals and cancer centres.
  • 57% of people who had a resection for pancreatic cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for pancreatic cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of pancreatic cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for pancreatic cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for pancreatic cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Pancreatic cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • The minimum recommended number of pancreatic cancer resections performed annually in NSW hospitals is six.
  • In 2018, the proportion of pancreatic cancer resections performed in NSW public hospitals above the minimum suggested annual caseload increased to 90%, compared with 82% in 2013.

Pancreatic cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of pancreatic cancer resections in July 2017-June 2018.

* Recommendation based on international studies, analysis of NSW data, and hospital-level distribution of pancreatectomies in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that have performed pancreatic cancer resections in July 2012–June 2013 or July 2017–June 2018 appear on this chart.

Pancreatic cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of pancreatic cancer resections performed in NSW private hospitals above the minimum suggested annual caseload increased to 94%, compared with 76% in 2012–13.

Pancreatic cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of pancreatic cancer resections in July 2017-June 2018.

* Recommendation based on international studies, analysis of NSW data, and hospital-level distribution of pancreatectomies in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed pancreatic cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, pancreatic cancer, 2015–2018

Key findings:

  • On average, 28% of patients in NSW public and 26% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for pancreatic cancer.
  • 20% of all patients undergoing surgery for pancreatic cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 13% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, pancreatic cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW public hospitals, pancreatic cancer, 2015–2018

Key findings:

  • On average, 28% of patients in NSW public and 26% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for pancreatic cancer.
  • 20% of all patients undergoing surgery for pancreatic cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 13% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, pancreatic cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Primary and secondary liver cancer

Primary liver cancer is a cancer that starts in the cells of the liver. Some cancers spread to the liver from other parts of the body, but they are known as secondary liver cancers.

The number of people being diagnosed with primary liver cancer increased significantly in NSW over the past 10 years.

There are a number of health problems that increase the risk of developing primary liver cancer. They include chronic hepatitis B and C infections, drinking alcohol at harmful levels, and being obese.

Primary liver cancer resections are complex surgery that should be performed at a hospital with expertise in this surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Hepatitis C

Hepatitis C is the leading cause of liver cancer in Australia.

Direct‑acting anti‑viral hepatitis C treatments have been developed and were listed on the Pharmaceutical Benefits Scheme in March 2016.

NSW Health has set a target to eliminate hepatitis C in NSW by 2028, with specific targets for each local health district.

To achieve this target, a key focus is to increase the proportion of hepatitis C treatment being initiated in primary care. General practitioners can now initiate treatment with or without the support of a specialist.

Such settings also include outpatient services, Aboriginal Community Controlled Health Services, correctional facilities, and drug and alcohol services, to ensure easy access for the most vulnerable communities.

Since March 2016, NSW has treated 29% (23,652) of people estimated to be living with hepatitis C, and access to treatment in general practice continues to rise. This treatment level is an increase from 25% (19,819) in the period March 2016 to December 2018.

Hepatitis C

Estimated proportion of NSW residents with hepatitis C initiating treatment, by local health district (LHD) of residence (ranked), March 2016–December 2018

Key findings:

  • Between March 2016 and December 2018, 29% of NSW residents with hepatitis C had initiated treatment. This is below the NSW 2018 target of 34%.
  • Estimated proportion of NSW residents with hepatitis C initiating treatment ranged between 16% and 47% across LHDs. 

Estimated proportion of NSW residents with hepatitis C initiating treatment, by local health district (LHD) of residence (ranked), March 2016–December 2018

N= Number of people estimated to be living with hepatitis C in 2016.

Notes:

1. Data source: Hepatitis C prevalence data sourced from 2017 Estimates and Projections of the Hepatitis C Virus Epidemic in NSW: Summary Report, Kirby Institute. Treatment data sourced from Pharmaceutical Benefits Schedule Highly Specialised Drugs Program data.

2. Health and/or specialty network figures were not available because data are reported by LHD of residence. This exclusion applies to St Vincent's Health Network, Sydney Children's Hospitals Network, and Justice Health and Forensic Mental Health.

Estimated proportion of NSW residents with hepatitis C initiating treatment, by prescriber type, by local health district (LHD) of residence (ranked), 1 July 2018–31 December 2018

Key finding:

  • Between July 2018 and December 2018, the percentage of general practitioners by LHD of practice initiating treatment for hepatitis C ranged from 27% to 88%.

Estimated proportion of NSW residents with hepatitis C initiating treatment, by prescriber type, by local health district (LHD) of residence (ranked), 1 July 2018–31 December 2018

N= Number of NSW residents initiating hepatitis C treatment.

Notes:

1. Data source: Hepatitis C prevalence data sourced from 2017 Estimates and Projections of the Hepatitis C Virus Epidemic in NSW: Summary Report, Kirby Institute. Treatment data sourced from Pharmaceutical Benefits Schedule Highly Specialised Drugs Program data.

2. General practitioner: Includes vocational registered, non-vocationally registered, trainee and unclassified.

3. Health and/or specialty network figures were not available because data are reported by LHD of residence. This exclusion applies to St Vincent's Health Network, Sydney Children's Hospitals Network, and Justice Health and Forensic Mental Health.

Primary liver cancer

Average annual flows of people for resection for primary liver cancer, by local health district (LHD) of residence, 2015–2018*

Key findings:

  • A primary liver cancer resection is complex surgery that is performed in only some LHDs.
  • 53% of people who had a resection for primary liver cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for primary liver cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of primary liver cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for primary liver cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for primary liver cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Primary liver cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key finding:

  • Between 2013 and 2018, the number of primary liver cancer resections performed in NSW public hospitals increased from 93 to 112.

Primary liver cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of primary liver cancer resections in 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed primary liver cancer resections in 2013 or 2018 appear on this chart.

Primary liver cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • Between 2013 and 2018, the number of primary liver cancer resections performed in NSW private hospitals increased from 48 to 70.

Primary liver cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of primary liver cancer resections in July 2017-June 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed primary liver cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, primary liver cancer, 2015–2018

Key findings:

  • On average, 13% of patients in NSW public and 16% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for liver cancer.
  • 13% of all patients undergoing surgery for liver cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 8% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, primary liver cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, primary liver cancer, 2015–2018

Key findings:

  • On average, 13% of patients in NSW public and 16% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for liver cancer.
  • 13% of all patients undergoing surgery for liver cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 8% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, primary liver cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Secondary liver cancer

Average annual flows of people for resection for secondary liver cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 57% of people who had a resection for secondary liver cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for secondary liver cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of secondary liver cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for secondary liver cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for secondary liver cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Secondary liver cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key findings:

  • Between 2013 and 2018, the number of secondary liver cancer resections performed in NSW public hospitals increased from 186 to 207.

Secondary liver cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of secondary liver cancer resections in 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed secondary liver cancer resections in 2013 or 2018 appear on this chart.

Secondary liver cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • Between 2012–13 and 2017–18, the number of secondary liver cancer resections performed in NSW private hospitals decreased from 142 to 138.

Secondary liver cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of secondary liver cancer resections in July 2017-June 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed secondary liver cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, secondary liver cancer, 2015–2018

Key findings:

  • On average, 9% of patients in NSW public and 7% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for secondary liver cancer.
  • 13% of all patients undergoing surgery for secondary liver cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 10% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, secondary liver cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, secondary liver cancer, 2015–2018

Key findings:

  • On average, 9% of patients in NSW public and 7% of patients in NSW private hospitals experience an extended stay greater than 21 days following surgery for secondary liver cancer.
  • 13% of all patients undergoing surgery for secondary liver cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 10% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, secondary liver cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Kidney cancer

Kidney cancer starts in the cells of the kidney. The most common type of kidney cancer is renal cell carcinoma, which accounts for around 90% of all kidney cancer cases.

The main treatment for kidney cancer is surgery to remove part or all of the kidney. This removal is called a nephrectomy, and it should be performed at a hospital with expertise in this type of surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for kidney cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 70% of people who had a resection for rectal cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for kidney cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of kidney cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for kidney cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for kidney cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Kidney cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key finding:

  • Between 2013 and 2018, the number of kidney cancer resections performed in NSW public hospitals increased from 412 to 446.

Kidney cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of kidney cancer resections in 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed kidney cancer resections in 2013 or 2018 appear on this chart.

Kidney cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • Between 2012–13 and 2017–18, the number of kidney cancer resections performed in NSW private hospitals increased from 422 to 496.

Kidney cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of kidney cancer resections in July 2017-June 2018.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed kidney cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Adjusted surgical outcomes in NSW public hospitals, kidney cancer, 2015–2018

Key findings:

  • On average, 17% of patients in NSW public and 16% of patients in NSW private hospitals experience an extended stay greater than seven days following surgery for kidney cancer.
  • Nine per cent of all patients undergoing surgery for kidney cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 5% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW public hospitals, kidney cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Adjusted surgical outcomes in NSW private hospitals, kidney cancer, 2015–2018

Key findings:

  • On average, 17% of patients in NSW public and 16% of patients in NSW private hospitals experience an extended stay greater than seven days following surgery for kidney cancer.
  • Nine per cent of all patients undergoing surgery for kidney cancer at NSW public hospitals experienced an unplanned (emergency) readmission within 28 days of the surgery. For patients attending NSW private hospitals, 5% experienced an unplanned (emergency) readmission.

Adjusted surgical outcomes in NSW private hospitals, kidney cancer, 2015–2018

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. For further information regarding data and definitions, refer to the surgical outcomes table and/or the 'Technical document' in the appendices.

Bladder cancer

Bladder cancer starts in the bladder and can invade the nearby muscles and organs, or affect distant organs.

Surgery for bladder cancer may involve total removal of the urinary bladder. This removal is called a total cystectomy, and should be performed at a hospital with expertise in this type of surgery.

The management of bladder cancer is complex and requires a team of health care professionals with suitable experience in providing appropriate care before and after surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for bladder cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 71% of people who had a resection for bladder cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for bladder cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of bladder cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for bladder cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for bladder cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Bladder cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key finding:

  • In 2018, the proportion of bladder cancer resections performed in NSW public hospitals above the minimum suggested annual caseload declined to 50%, compared with 69% in 2013.

Bladder cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of bladder cancer resections in 2018.

* Bladder cancer recommendation based on international studies and local clinician endorsement.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed bladder cancer resections in 2013 or 2018 appear on this chart.

Bladder cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of bladder cancer resections performed in NSW private hospitals above the minimum suggested annual caseload declined to 59%, compared with 71% in 2012–13.

Bladder cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of bladder cancer resections in July 2017-June 2018.

* Bladder cancer recommendation based on international studies and local clinician endorsement.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed bladder cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Complex head and neck cancer

The term ‘head and neck cancers’ incorporates a number of different cancer types that start in different parts of the head and neck (e.g. mouth, throat (larynx), salivary glands, etc.).

The location of some head and neck cancers means their surgery can be very complex. There is evidence of improved survival from having surgery for complex head and neck cancer in a specialist cancer centre or hospital. [67,68]

The management of these cancers requires a team of health care professionals with suitable experience in providing appropriate care before and after surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for complex head and neck cancer, by local health district (LHD) of residence, 2015–2018*

Key findings:

  • Complex head and neck cancer resections are performed in mostly LHDs with larger hospitals and cancer centres.
  • 46% of people who had a resection for head and neck cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for complex head and neck cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of complex head and neck resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1 .Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for complex head and neck cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for complex head and neck cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Complex head and neck cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key finding:

  • In 2018, the proportion of complex head and neck cancer resections performed in NSW public hospitals above the minimum suggested annual caseload remained consistent at 83%, compared with 85% in 2013.

Complex head and neck cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of complex head and neck cancer resections in 2018.

* Recommendation based on local Clinical Advisory Group endorsement.

** In November 2013, Royal Prince Alfred Hospital cancer services began transitioning to Chris O'Brien Lifehouse.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed head and neck cancer resections in 2013 or 2018 appear on this chart.

Complex head and neck cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of complex head and neck cancer resections performed in NSW private hospitals above the minimum suggested annual caseload decreased to 55%, compared with 66% in 2012–13.

Complex head and neck cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of complex head and neck cancer resections in July 2017-June 2018.

* Recommendation based on local Clinical Advisory Group endorsement.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed head and neck cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.

Neurological cancer

Neurological cancers can start in the brain (primary brain tumours), or other nerves including the spinal cord, or can be caused by cancers elsewhere in the body (secondary brain tumours). This section reports only primary neurological cancers.

The management of neurological (brain) cancer is complex. People with brain cancer should be referred to a hospital that has a team of health care professionals with experience in neurological cancer treatment, including medical and radiation oncologists.

For optimal care, people with brain cancer should consult with a neurosurgeon who has expertise in brain cancer surgery.

A key focus within the NSW Cancer Plan is to ensure all people diagnosed with cancer in NSW have their care overseen by a multidisciplinary cancer care team of health professionals.

Average annual flows of people for resection for neurological cancer, by local health district (LHD) of residence, 2015–2018*

Key finding:

  • 50% of people who had a resection for neurological cancer had the surgery in their LHD of residence.

Average annual flows of people for resection for neurological cancer, by local health district (LHD) of residence, 2015–2018*

N= Number of neurological cancer resections in 2015-2018.

* Private hospital data included in these figures are from July 2015 to June 2018.

ᴧ Private hospital data are not available for these LHDs. Either one private hospital performs surgeries or one private hospital performs more than 90% of surgeries in these LHDs.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Outside LHD of residence: Facilities outside LHD of residence include other NSW LHDs and interstate public facilities.

Average annual flows of people for resection for neurological cancer, by local health district (LHD) of residence, 2015–2018

Average annual flows of people for resection for neurological cancer, by local health district (LHD) of residence, 2015–2018

* Any inconsistencies in totals are due to rounding averages to the nearest whole number.

** NwV = Network with Victoria; StVHN = St Vincent's Health Network; SCHN = Sydney Children's Hospital Network.

ᴧ Total resections = NSW hospitals (public and private) + interstate + NwV** + SCHN**.

L Proportion of people treated in a public hospital within the LHD they live in.

┘Proportion of people treated in a public or private hospital within the LHD they live in.

Neurological cancer resections in NSW public hospitals (ranked), 2013 and 2018

Key finding:

  • In 2018, the proportion of neurological cancer resections performed in NSW public hospitals above the minimum suggested annual caseload remained consistent at 94%, compared with 96% in 2013.

Neurological cancer resections in NSW public hospitals (ranked), 2013 and 2018

N= Number of neurological cancer resections in 2018.

* Recommendation based on hospital-level distribution of neurological cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed neurological cancer resections in 2013 or 2018 appear on this chart.

Neurological cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

Key finding:

  • In 2017–18, the proportion of neurological cancer resections performed in NSW private hospitals above the minimum caseload increased to 94%, compared with 87% in 2012–13.

Neurological cancer resections in NSW private hospitals (ranked), July 2012–June 2013 and July 2017–June 2018

N= Number of neurological cancer resections in July 2017-June 2018.

* Recommendation based on hospital-level distribution of neurological cancer resections in NSW.

Notes:

1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).

2. Only hospitals that performed neurological cancer resections in July 2012-June 2013 or July 2017-June 2018 appear on this chart.


Why are different time periods and dates reported?

Cancer information is collected from many different sources, so it takes time to review and analyse the data. Different pieces of information may be collected over different time periods, or reported at different times. This means not all the measures reported here have the same dates.

The information presented is the most recent available for each measure at the time this report was written.

Why are confidence intervals reported here?

Confidence intervals are included when a small sample is used to represent the overall population, because there is a chance of an error due to this scaling.

In this report, a 95% confidence interval is presented only on charts where a sample of the population is used. This interval can be thought of as a margin of error.

The larger the sample size, the smaller the confidence interval range. The smaller the sample size, the larger the confidence interval range.