Anuhya Kommalapati1, Sri Harsha Tella1, Gaurav Goyal2, Mitesh Borad3, Steven R Alberts2, Lewis Roberts2, Joleen M Hubbard2, Lori Durgin2, Sean Cleary4, Amit Mahipal5. 1. Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, SC, USA. 2. Department of Oncology, Mayo Clinic, Rochester, MN, USA. 3. Department of Oncology, Mayo Clinic, Scottsdale, AZ, USA. 4. Department of Surgery, Mayo Clinic, Rochester, MN, USA. 5. Department of Oncology, Mayo Clinic, Rochester, MN, USA. Electronic address: mahipal.amit@mayo.edu.
Abstract
BACKGROUND: To determine the association between the number of patients with intra-hepatic cholangiocarcinoma (IHCC) treated annually at a treatment facility (volume) and overall survival (outcome). METHODS: Patients with IHCC reported to the National Cancer Database (years 2004-2015) were included. We classified facilities by tertiles (T; mean IHCC patients treated/year): T1: <2.56; T2: 2.57-5.39 and T3: ≥5.40. Volume-outcome relationship was determined by using Cox regression adjusting for patient demographics, comorbidities, tumor characteristics, insurance type and therapy received. RESULTS: There were 11,344 IHCC patients treated at 1106 facilities. On multivariable analysis, facility volume was independently associated with all-cause mortality (p < 0.001). The unadjusted median OS by facility volume was: T1: 5 months (m), T2: 8.1 m, and T3: 13.1 m (p < 0.001). Compared with patients treated at T3 facilities, patients treated at lower-tertile facilities had significantly higher risk of death [T2 hazard ratio (HR), 1.12 [95% CI, 1.05-1.23]; T1 HR, 1.21 [95% CI, 1.11-1.33]. Patients treated at high-volume centers were more likely to get surgery (34.6 vs 13.1%) and adjuvant therapy. CONCLUSION: IHCC patients treated at high-volume facilities had a significant improvement in OS and were more likely to receive surgery and adjuvant therapy as compared to that of patients at low-volume facilities.
BACKGROUND: To determine the association between the number of patients with intra-hepatic cholangiocarcinoma (IHCC) treated annually at a treatment facility (volume) and overall survival (outcome). METHODS:Patients with IHCC reported to the National Cancer Database (years 2004-2015) were included. We classified facilities by tertiles (T; mean IHCC patients treated/year): T1: <2.56; T2: 2.57-5.39 and T3: ≥5.40. Volume-outcome relationship was determined by using Cox regression adjusting for patient demographics, comorbidities, tumor characteristics, insurance type and therapy received. RESULTS: There were 11,344 IHCC patients treated at 1106 facilities. On multivariable analysis, facility volume was independently associated with all-cause mortality (p < 0.001). The unadjusted median OS by facility volume was: T1: 5 months (m), T2: 8.1 m, and T3: 13.1 m (p < 0.001). Compared with patients treated at T3 facilities, patients treated at lower-tertile facilities had significantly higher risk of death [T2 hazard ratio (HR), 1.12 [95% CI, 1.05-1.23]; T1 HR, 1.21 [95% CI, 1.11-1.33]. Patients treated at high-volume centers were more likely to get surgery (34.6 vs 13.1%) and adjuvant therapy. CONCLUSION: IHCC patients treated at high-volume facilities had a significant improvement in OS and were more likely to receive surgery and adjuvant therapy as compared to that of patients at low-volume facilities.
Authors: Lu Wu; Diamantis I Tsilimigras; Anghela Z Paredes; Rittal Mehta; J Madison Hyer; Katiuscha Merath; Kota Sahara; Fabio Bagante; Eliza W Beal; Feng Shen; Timothy M Pawlik Journal: World J Surg Date: 2019-07 Impact factor: 3.352
Authors: May T Cho; Sepideh Gholami; Dorina Gui; Sooraj L Tejaswi; Ghaneh Fananapazir; Nadine Abi-Jaoudeh; Zeljka Jutric; Jason B Samarasena; Xiaodong Li; Jennifer B Valerin; Jacob Mercer; Farshid Dayyani Journal: Cancers (Basel) Date: 2022-01-13 Impact factor: 6.639