So I had to pick a center back in June after diagnosis and honestly the metrics they throw at you don't always tell you what you need to know. Everyone wants to see survival rates and five year outcomes but that's not the whole picture.
First thing I did was ask each center what their pleurectomy numbers looked like for that year. Not lifetime. That year. One place told me they do maybe 12 a year, another said 40 plus. The high volume place had better outcomes but that's not everything either.
I asked about their multimodal approach too. Can they do surgery then chemo then radiation all coordinated or are you bouncing between departments. My center in Norfolk had pulmonary, oncology, and radiation all in one building which sounds like it shouldn't matter but it does when you're recovering.
One thing nobody talks about is complication rates. Ask them straight up what percentage of their patients get post op infections or need a second surgery. They might not answer but some will. The center I went with had lower infection rates than the national average which meant something to me.
Also ask how many cases they've done in the last three years specifically. New centers might have great metrics on paper but limited experience. I wanted someone who'd seen a lot of Stage II pleural cases.
The survival numbers are important but they're lagging. By the time you see their published five year data it's already five years old. Ask them what they're doing now that's different. New trials, different chemo combos, whatever.
I also called some guys who'd been treated there. The center let me talk to two patients about three months post op. That told me more than any brochure.