OBJECTIVE: This study investigates associations between hospital and surgeon volume, and racial differences in recurrence after surgery for prostate cancer. METHODS: Data from the 1991 to 2002 Surveillance, Epidemiology, and End-Results-Medicare database were examined for 962 black and 7387 white men who received surgery for prostate cancer within 6 months of diagnosis during 1993-1999. Cox regression models were used to estimate the relationships between volume (grouped in tertiles), recurrence or death, and race, controlling for age, Gleason grade, and comorbidity score. RESULTS: Prostate cancer recurrence-free survival rates improved with hospital and surgical volume. Black men were more likely to experience recurrence than white men [hazard ratio (HR) = 1.34; 95% confidence interval (CI): 1.20-1.50]. Stratification by hospital volume revealed that racial differences persisted for medium and high volume hospitals, even after covariate adjustments (medium HR = 1.30, 95% CI: 1.04-1.61; high HR = 1.36, 95% CI: 1.07-1.73). Racial differences persisted within medium and high levels of surgeon volume as well (medium HR = 1.43, 95% CI: 1.10-1.85; high HR = 1.57, 95% CI: 1.14-2.16). CONCLUSIONS: High hospital and physician volumes were not associated with reduced racial differences in recurrence-free survival after prostate cancer surgery, contrary to expectation. This study suggests that social and behavioral characteristics, and some aspects of access, may play a larger role than organizational or systemic characteristics with regard to recurrence-free survival for this population.
OBJECTIVE: This study investigates associations between hospital and surgeon volume, and racial differences in recurrence after surgery for prostate cancer. METHODS: Data from the 1991 to 2002 Surveillance, Epidemiology, and End-Results-Medicare database were examined for 962 black and 7387 white men who received surgery for prostate cancer within 6 months of diagnosis during 1993-1999. Cox regression models were used to estimate the relationships between volume (grouped in tertiles), recurrence or death, and race, controlling for age, Gleason grade, and comorbidity score. RESULTS:Prostate cancer recurrence-free survival rates improved with hospital and surgical volume. Black men were more likely to experience recurrence than white men [hazard ratio (HR) = 1.34; 95% confidence interval (CI): 1.20-1.50]. Stratification by hospital volume revealed that racial differences persisted for medium and high volume hospitals, even after covariate adjustments (medium HR = 1.30, 95% CI: 1.04-1.61; high HR = 1.36, 95% CI: 1.07-1.73). Racial differences persisted within medium and high levels of surgeon volume as well (medium HR = 1.43, 95% CI: 1.10-1.85; high HR = 1.57, 95% CI: 1.14-2.16). CONCLUSIONS: High hospital and physician volumes were not associated with reduced racial differences in recurrence-free survival after prostate cancer surgery, contrary to expectation. This study suggests that social and behavioral characteristics, and some aspects of access, may play a larger role than organizational or systemic characteristics with regard to recurrence-free survival for this population.
Authors: Willie Underwood; James Jackson; John T Wei; Rodney Dunn; Edmond Baker; Sonya Demonner; David P Wood Journal: Cancer Date: 2005-02-01 Impact factor: 6.860
Authors: Jacob H Cohen; Victor J Schoenbach; Jay S Kaufman; James A Talcott; Anna P Schenck; Sharon Peacock; Michael Symons; M Ahinee Amamoo; William R Carpenter; Paul A Godley Journal: Cancer Causes Control Date: 2006-08 Impact factor: 2.506
Authors: Ashutosh Tewari; Wolfgang Horninger; Alexandre E Pelzer; Raymond Demers; E David Crawford; Eduard J Gamito; George Divine; Christine Cole Johnson; George Bartsch; Mani Menon Journal: BJU Int Date: 2005-12 Impact factor: 5.588
Authors: Colin B Begg; Elyn R Riedel; Peter B Bach; Michael W Kattan; Deborah Schrag; Joan L Warren; Peter T Scardino Journal: N Engl J Med Date: 2002-04-11 Impact factor: 91.245
Authors: M Nawal Lutfiyya; Deepa K Bhat; Seema R Gandhi; Catherine Nguyen; Vicki L Weidenbacher-Hoper; Martin S Lipsky Journal: Int J Qual Health Care Date: 2007-04-18 Impact factor: 2.038
Authors: Anne Marie McCarthy; Mirar Bristol; Susan M Domchek; Peter W Groeneveld; Younji Kim; U Nkiru Motanya; Judy A Shea; Katrina Armstrong Journal: J Clin Oncol Date: 2016-05-09 Impact factor: 44.544
Authors: Quoc-Dien Trinh; Anders Bjartell; Stephen J Freedland; Brent K Hollenbeck; Jim C Hu; Shahrokh F Shariat; Maxine Sun; Andrew J Vickers Journal: Eur Urol Date: 2013-04-19 Impact factor: 20.096
Authors: Craig Evan Pollack; Hao Wang; Justin E Bekelman; Gary Weissman; Andrew J Epstein; Kaijun Liao; Eva H Dugoff; Katrina Armstrong Journal: Value Health Date: 2014-06-23 Impact factor: 5.725
Authors: William R Carpenter; Katherine Reeder-Hayes; John Bainbridge; Anne-Marie Meyer; Keith D Amos; Bryan J Weiner; Paul A Godley Journal: Med Care Date: 2011-02 Impact factor: 2.983
Authors: Michael J Hassett; Debra P Ritzwoller; Nathan Taback; Nikki Carroll; Angel M Cronin; Gladys V Ting; Deb Schrag; Joan L Warren; Mark C Hornbrook; Jane C Weeks Journal: Med Care Date: 2014-10 Impact factor: 2.983
Authors: Daniel A Barocas; Darryl T Gray; Jay H Fowke; Nathaniel D Mercaldo; Jeffrey D Blume; Sam S Chang; Michael S Cookson; Joseph A Smith; David F Penson Journal: J Urol Date: 2012-08-16 Impact factor: 7.450
Authors: Adil H Haider; Valerie K Scott; Karim A Rehman; Catherine Velopulos; Jessica M Bentley; Edward E Cornwell; Waddah Al-Refaie Journal: J Am Coll Surg Date: 2013-01-11 Impact factor: 6.113