Identifying the type and extent of these effects after cancer surgery worldwide is important to broaden understanding, guide further research, and inform national surgical plans. InterpretationĮxcess mortality after cancer surgery in low-income and middle-income countries (LMICs) has been described previously, but the effects of hospital facilities on early patient outcomes are unknown. Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio 3♸5 p<0♰001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63♰% vs 82♷% OR 0♳5 p<0♰001). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. The Lancet Regional Health – Western Pacificīetween April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries 57 hospitals in 19 upper-middle-income countries and 90 hospitals in 27 low-income to lower-middle-income countries).The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.

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