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This systematic review\/meta-analysis assessed the impact of hospital volume on postoperative outcomes after esophagogastric surgery and identified volume thresholds beyond which benefits plateau.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE was searched for cohort studies (2013\u20132023) on volume and outcomes after esophagectomy\/gastrectomy for cancer. Primary outcome was 30-day mortality. Secondary outcomes included 90-day mortality, complications, length of stay (LOS), and long-term survival. The meta-analysis compared hospital volumes using odds ratios (ORs) for binary outcomes, hazard ratios (HRs) for survival, and mean differences (MDs) for LOS. A generalized estimating equation model assessed the continuous association between volume and 30-day mortality. Segmented regression identified volume thresholds where outcomes plateaued.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 2679 articles, 56 studies on hospital volume and outcomes after esophagectomy and gastrectomy for cancer were included. High-volume hospitals (4\u2013239 resections\/year) showed lower 30-day mortality (OR 0.51; 95% confidence interval [CI] 0.43\u20130.59), 90-day mortality (OR 0.65; 95% CI 0.56\u20130.74), fewer complications (OR 0.83; 95% CI 0.74\u20130.94), shorter LOS (MD -1.50 days; 95% CI 0.97\u20132.03), and better survival (HR 0.83; 95% CI 0.78\u20130.87). Each doubling of volume demonstrated a significant reduction in 30-day mortality for esophagectomy (OR\/volume-doubling 0.74; 95% CI 0.68\u20130.81) and gastrectomy (OR\/volume-doubling 0.70; 95% CI 0.61\u20130.82). Breakpoints were identified at 43 cases for esophagectomy and 15 cases for gastrectomy per year, beyond which the association plateaued.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher hospital volume is associated with lower mortality, reduced complications, shorter LOS, and improved survival. Identified thresholds exceed existing policy benchmarks, supporting further centralization of esophagogastric cancer surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-026-19558-5","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T12:24:18Z","timestamp":1775046258000},"page":"7088-7100","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Impact of Hospital Volume on Postoperative Outcomes for Esophagectomy and Gastrectomy: A Systematic Review and Meta-analysis"],"prefix":"10.1245","volume":"33","author":[{"given":"Cezanne D.","family":"Kooij","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene S.","family":"Zuin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Challine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie A.","family":"Elliott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle P.","family":"Ruurda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"van Hillegersberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Goense","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"issue":"6","key":"19558_CR1","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.1342","volume":"6","author":"A Mazidimoradi","year":"2023","unstructured":"Mazidimoradi A, Ghavidel F, Momenimovahed Z, et al. 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