Iwatsuki M, et al. - Researchers conducted this study to clarify how surgeon and hospital volume influence postoperative mortality after distal gastrectomy for gastric cancer among Japanese patients in a nationwide web-based data entry system. They divided hospital volume into three tertiles (low: 1–22 cases per year; medium: 23–51; and high: 52–404) and surgeon volume into the 5 groups (0–3, 4–10, 11–20, 21–50, 51 + cases per year). Upon evaluating data from 145,523 patients at 2,182 institutions, they noted that hospital volume was significantly associated with operative mortality after risk adjustment for surgeon and hospital volume and patient characteristics. These findings suggested the value of centralization in improving outcomes after distal gastrectomy.