Naomi van der Linden1, Mathilda L Bongers2, Veerle M H Coupé2, Egbert F Smit3, Harry J M Groen4, Alle Welling5, Franz M N H Schramel6, Carin A Uyl-de Groot7. 1. Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia. Electronic address: naomi.vanderlinden@chere.uts.edu.au. 2. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands. 3. Pulmonology, VU University Medical Center, Amsterdam, the Netherlands; Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands. 4. Department of Pulmonary Diseases, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands. 5. Department of Pulmonology, Medical Center Alkmaar, Alkmaar, the Netherlands. 6. Department of Pulmonology, St. Antonius Hospital, Nieuwegein, the Netherlands. 7. Institute for Medical Technology Assessment, Erasmus University, Rotterdam, the Netherlands.
Abstract
BACKGROUND: The aims of this study are to analyze differences in survival between academic and non-academic hospitals and to provide insight into treatment patterns for non-small cell lung cancer (NSCLC). Results show the state of NSCLC survival and care in the Netherlands. METHODS: The Netherlands Cancer Registry provided data on NSCLC survival for all Dutch hospitals. We used the Kaplan-Meier estimate to calculate median survival time by hospital type and a Cox proportional hazards model to estimate the relative risk of mortality (expressed as hazard ratios) for patients diagnosed in academic versus non-academic hospitals, with adjustment for age, gender, and tumor histology, and stratifying for disease stage. Data on treatment patterns in Dutch hospitals was obtained from 4 hospitals (2 academic, 2 non-academic). A random sample of patients diagnosed with NSCLC from January 2009 until January 2011 was identified through hospital databases. Data was obtained on patient characteristics, tumor characteristics, and treatments. RESULTS: The Cox proportional hazards model shows a significantly decreased hazard ratio of mortality for patients diagnosed in academic hospitals, as opposed to patients diagnosed in non-academic hospitals. This is specifically true for primary radiotherapy patients and patients who receive systemic treatment for non-metastasized NSCLC. CONCLUSION: Patients diagnosed in academic hospitals have better median overall survival than patients diagnosed in non-academic hospitals, especially for patients treated with radiotherapy, systemic treatment, or combinations. This difference may be caused by residual confounding since the estimates were not adjusted for performance status. A wide variety of surgical, radiotherapeutic, and systemic treatments is prescribed.
BACKGROUND: The aims of this study are to analyze differences in survival between academic and non-academic hospitals and to provide insight into treatment patterns for non-small cell lung cancer (NSCLC). Results show the state of NSCLC survival and care in the Netherlands. METHODS: The Netherlands Cancer Registry provided data on NSCLC survival for all Dutch hospitals. We used the Kaplan-Meier estimate to calculate median survival time by hospital type and a Cox proportional hazards model to estimate the relative risk of mortality (expressed as hazard ratios) for patients diagnosed in academic versus non-academic hospitals, with adjustment for age, gender, and tumor histology, and stratifying for disease stage. Data on treatment patterns in Dutch hospitals was obtained from 4 hospitals (2 academic, 2 non-academic). A random sample of patients diagnosed with NSCLC from January 2009 until January 2011 was identified through hospital databases. Data was obtained on patient characteristics, tumor characteristics, and treatments. RESULTS: The Cox proportional hazards model shows a significantly decreased hazard ratio of mortality for patients diagnosed in academic hospitals, as opposed to patients diagnosed in non-academic hospitals. This is specifically true for primary radiotherapy patients and patients who receive systemic treatment for non-metastasized NSCLC. CONCLUSION:Patients diagnosed in academic hospitals have better median overall survival than patients diagnosed in non-academic hospitals, especially for patients treated with radiotherapy, systemic treatment, or combinations. This difference may be caused by residual confounding since the estimates were not adjusted for performance status. A wide variety of surgical, radiotherapeutic, and systemic treatments is prescribed.
Authors: J de Castro; P Tagliaferri; V C C de Lima; S Ng; M Thomas; A Arunachalam; X Cao; S Kothari; T Burke; H Myeong; A Grattan; D H Lee Journal: Eur J Cancer Care (Engl) Date: 2017-07-27 Impact factor: 2.520
Authors: Fernando Conrado Abrão; Frederico Rafael Moreira; Igor Renato Louro Bruno de Abreu; Marcelo Giovanni Marciano; Riad Naim Younes Journal: JCO Glob Oncol Date: 2021-09