BACKGROUND: We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancer patients. METHODS: Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers. RESULTS: Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81). CONCLUSION: Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancer patients should be considered in formulating or revising national health policy.
BACKGROUND: We conducted a population-based retrospective cohort study to investigate the influence of hospital volume, delay of surgery, and both together on the long-term survival of postoperative cancerpatients. METHODS: Using information from the Korea Central Cancer Registry from 2001 through 2005 and the National Health Insurance claim database, we determined survival for 147 682 patients who underwent definitive surgery for any of six cancers. RESULTS:Regardless of cancer site, surgical patients in low- to medium-volume hospitals showed significantly worse survival [adjusted hazard ratio (aHR) = 1.36-1.86] than those in high-volume hospitals in multivariable analyses. Among the latter, treatment delays > 1 month were not associated with worse survival for stomach, colon, pancreatic, or lung cancer but were for rectal [aHR = 1.28; 95% confidence interval (CI), 1.17-1.40] and breast (aHR = 1.59; 95% CI, 1.37-1.84) cancer. For patients in low- to medium-volume hospitals, treatment delay was associated with worse survival for all types of cancer (aHR = 1.78-3.81). CONCLUSION: Our findings suggest that the effect of hospital volume and surgical treatment delay on overall survival of cancerpatients should be considered in formulating or revising national health policy.
Authors: Stephan Kruger; Karoline Schirle; Michael Haas; Alexander Crispin; Jörg Schirra; Julia Mayerle; Jan G D'Haese; Wolfgang G Kunz; Jens Ricke; Steffen Ormanns; Thomas Kirchner; Sebastian Kobold; Matthias Ilmer; Leonie Gebauer; Christoph B Westphalen; Michael von Bergwelt-Baildon; Jens Werner; Volker Heinemann; Stefan Boeck Journal: J Cancer Res Clin Oncol Date: 2019-10-23 Impact factor: 4.553
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Authors: Antonieta Medina-Lara; Bogdan Grigore; Ruth Lewis; Jaime Peters; Sarah Price; Paolo Landa; Sophie Robinson; Richard Neal; William Hamilton; Anne E Spencer Journal: Health Technol Assess Date: 2020-11 Impact factor: 4.014
Authors: Christian H Flores-Balcázar; Ma L Flores-Luna; Cynthia M Villarreal-Garza; Juan E Bargalló-Rocha Journal: Rep Pract Oncol Radiother Date: 2020-02-21