High-Volume Center

A high-volume center is a hospital or cancer program that treats a large number of patients with a specific disease (in the asbestos context, usually mesothelioma) each year. These centers tend to have specialized surgeons, pathologists, oncologists, and multidisciplinary teams who see mesothelioma cases routinely rather than rarely. Research consistently shows that patients treated at high-volume centers for complex cancers often have better outcomes, including lower surgical complication rates and longer survival.

Origin

The term emerged from health services research in the 1980s and 1990s showing a "volume-outcome relationship" for complex surgeries such as pancreatic, esophageal, and thoracic procedures. Studies by Birkmeyer and others at Dartmouth and Memorial Sloan Kettering helped establish that institutional and surgeon case volume independently predict patient survival.

Significance in Asbestos Context

Mesothelioma is rare (roughly 3,000 U.S. cases per year), so most community hospitals see only a handful of patients ever. Treatment decisions about pleurectomy/decortication, extrapleural pneumonectomy, hyperthermic chemotherapy (HIPEC), immunotherapy combinations, and clinical trial eligibility are highly specialized, and outcomes differ meaningfully depending on where care is delivered. For patients newly diagnosed, seeking evaluation at a recognized mesothelioma program (such as Brigham and Women's, MD Anderson, Memorial Sloan Kettering, UCLA, Penn, Baylor, or NCI-designated comprehensive cancer centers with mesothelioma teams) can change which treatments are offered and whether the pathology diagnosis is even correct. Mesothelioma is frequently misdiagnosed by general pathologists. Records from a high-volume center also tend to be more detailed about exposure history, fiber type, and disease staging, which can matter later for a legal claim.

Example Sentence

After her initial diagnosis at a local hospital, she sought a second opinion at a high-volume mesothelioma center, where the surgical team confirmed she was a candidate for pleurectomy/decortication followed by immunotherapy.

Related Terms

Multidisciplinary Care, Pleurectomy/Decortication, Extrapleural Pneumonectomy, Second Opinion, NCI-Designated Cancer Center, Clinical Trial

Notes

• Ask any oncologist how many mesothelioma cases their center treats per year; fewer than 10–15 is generally considered low-volume for this disease.
• Request that biopsy slides be sent to a high-volume center for pathology review. Mesothelioma is commonly confused with adenocarcinoma, sarcoma, or reactive pleural conditions, and the subtype (epithelioid, sarcomatoid, biphasic) drives treatment decisions.
• Travel and lodging assistance is often available through organizations like the Mesothelioma Applied Research Foundation, the American Cancer Society Hope Lodge, and hospital social work departments.
• Keep copies of all consultation notes, pathology reports, and imaging from every center you visit; consolidated records help both ongoing treatment and any future legal claim.
• Ask whether the center participates in mesothelioma-specific clinical trials, as access to novel therapies is one of the main advantages of high-volume programs.