Number of hospitals performing complex cancer surgeries above the minimum suggested annual caseload

Why this indicator is important

Evidence shows people who need complex surgery for certain cancers are better off to have it done at a hospital that performs these procedures more often.1

It is recommended that hospitals treating people with complex cancers perform these surgeries regularly (i.e. perform a certain number of surgeries each year). This is known as a minimum suggested annual caseload.

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 (MDT) of health professionals with suitable experience in providing appropriate care following surgery.

Surgical procedures performed for lung, oesophageal, pancreatic and rectal cancers are examples of complex surgery. The minimum suggested annual caseload for these treatments have been agreed with clinicians in NSW to improve patient outcomes.2-5

About this indicator

The graph below shows the proportion of resections for lung, oesophageal, pancreatic and rectal cancers that were performed in NSW hospitals (public and private) above the relevant minimum suggested annual caseload. 

It also shows the number of hospitals that performed these surgeries in 2014 and 2019.

For example, for lung cancer surgery in 2014, 16 hospitals performed surgeries above the minimum suggested annual caseload, and 87% of lung cancer resections took place in these hospitals. In 2019, this increased to 18 hospitals and 89% of surgeries.

Proportion of resections performed in NSW public and private hospitals above minimum suggested annual caseload and number of hospitals performing these surgeries, by cancer type, 2014 and 2019

N1 = Number of resections in 2019.

N2 = Number of resections in 2014.

* 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’. Caseloads are established through clinical endorsement, international studies and analyses of hospital-level data. The minimum suggested annual caseload for lung cancer is 18 resections; pancreatic and oesophageal cancers are 6 resections; and rectal cancer is 12 resections.


1. Data source: Admitted Patient, Emergency Department Attendance and Deaths Register (sourced from SAPHaRI, Centre for Epidemiology and Evidence, NSW Ministry of Health).
2. Resections at Albury Base Hospital have not been included in this report because this hospital reports services to the Victorian Department of Health. Resections in the two children's hospitals are also excluded.


  1. Currow DC, You H, Aranda S, McCaughan BC, Morrell S, Baker DF, et al. What factors are predictive of surgical resection and survival from localised non-small cell lung cancer? Med J Aust 2014 Oct 14;201(8):475–480.
  2. Brusselaers N, Mattsson F, Lagergren J. Hospital and surgeon volume in relation to long-term survival after oesophagectomy: systematic review and meta-analysis. Gut. 2014;63(9):1393-400. doi: 10.1136/gutjnl-2013-306074.
  3. Luchtenborg M, Riaz SP, Coupland VH, Lim E, Jakobsen E, Krasnik M, et al. High procedure volume is strongly associated with improved survival after lung cancer surgery. J Clin Oncol. 2013;31(25):3141-6. doi: 10.1200/JCO.2013.49.0219.
  4. Morche J, Mathes T, Pieper D. Relationship between surgeon volume and outcomes: a systematic review of systematic reviews. Syst Rev. 2016;5(1):204. doi: 10.1186/s13643-018-0872-9.
  5. Reames BN, Ghaferi AA, Birkmeyer JD, Dimick JB. Hospital volume and operative mortality in the modern era. Ann Surg. 2014;260(2):244-51. doi: 10.1097/SLA.0000000000000375.
  6. Munro A, Brown M, Niblock P, Steele R, Carey F. Do Multidisciplinary Team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686. doi: 10.1186/s12885-015-1683-1.