BACKGROUND: This study evaluates the influence of facility case-volume on nasopharyngeal carcinoma (NPC) treatments and overall survival (OS). METHODS: The 2004-2015 National Cancer Database was queried for patients with NPC receiving definitive treatment. RESULTS: A total of 8260 patients (5-year OS: 63.4%) were included. The 1114 unique facilities were categorized into 854 low-volume (treating 1-8 patients), 200 intermediate-volume (treating 9-23 patients), and 60 high-volume (treating 24-187 patients) facilities. Kaplan-Meier log-rank analysis demonstrated significantly improved OS with high-volume facilities (p < 0.001). On cox proportional-hazard multivariate regression after adjusting for age, sex, income, insurance, comorbidity index, histology, AJCC clinical stage, and treatment type, high-volume facilities were associated with lower mortality risk than low-volume (HR = 0.865, p = 0.019) and intermediate-volume facilities (HR = 0.916, p = 0.004). Propensity score matching analysis confirmed this association (p < 0.001). CONCLUSION: Higher facility volume was an independent predictor of improved OS in NPC, suggesting a possible survival benefit of referrals to high-volume medical centers.
BACKGROUND: This study evaluates the influence of facility case-volume on nasopharyngeal carcinoma (NPC) treatments and overall survival (OS). METHODS: The 2004-2015 National Cancer Database was queried for patients with NPC receiving definitive treatment. RESULTS: A total of 8260 patients (5-year OS: 63.4%) were included. The 1114 unique facilities were categorized into 854 low-volume (treating 1-8 patients), 200 intermediate-volume (treating 9-23 patients), and 60 high-volume (treating 24-187 patients) facilities. Kaplan-Meier log-rank analysis demonstrated significantly improved OS with high-volume facilities (p < 0.001). On cox proportional-hazard multivariate regression after adjusting for age, sex, income, insurance, comorbidity index, histology, AJCC clinical stage, and treatment type, high-volume facilities were associated with lower mortality risk than low-volume (HR = 0.865, p = 0.019) and intermediate-volume facilities (HR = 0.916, p = 0.004). Propensity score matching analysis confirmed this association (p < 0.001). CONCLUSION: Higher facility volume was an independent predictor of improved OS in NPC, suggesting a possible survival benefit of referrals to high-volume medical centers.
Authors: Chidinma P Anakwenze; Susan McGovern; Nicolette Taku; Kaiping Liao; David R Boyce-Fappiano; Carlos Kamiya-Matsuoka; Amol Ghia; Caroline Chung; Daniel Trifiletti; Sherise D Ferguson; Jing Li; Debra Nana Yeboa Journal: World Neurosurg Date: 2020-05-11 Impact factor: 2.104
Authors: John F Scoggins; Catherine R Fedorenko; Sara M A Donahue; Dedra Buchwald; David K Blough; Scott D Ramsey Journal: J Rural Health Date: 2011-03-31 Impact factor: 4.333
Authors: Christine G Gourin; Arlene A Forastiere; Giuseppe Sanguineti; Shanthi Marur; Wayne M Koch; Robert E Bristow Journal: Laryngoscope Date: 2011-04 Impact factor: 3.325
Authors: John M David; Allen S Ho; Michael Luu; Emi J Yoshida; Sungjin Kim; Alain C Mita; Kevin S Scher; Stephen L Shiao; Mourad Tighiouart; Zachary S Zumsteg Journal: Cancer Date: 2017-06-22 Impact factor: 6.860
Authors: Gaurav Goyal; Sri Harsha Tella; Shealeigh Funni; Anuhya Kommalapati; Jonathan W Inselman; Nilay D Shah; Ronald S Go; Stephen M Ansell Journal: Cancer Date: 2019-11-12 Impact factor: 6.860
Authors: Antoine Eskander; Jonathan Irish; Patti A Groome; Jeremy Freeman; Patrick Gullane; Ralph Gilbert; Stephen F Hall; David R Urbach; David P Goldstein Journal: Laryngoscope Date: 2014-06-03 Impact factor: 3.325
Authors: Karyn B Stitzenberg; Elin R Sigurdson; Brian L Egleston; Russell B Starkey; Neal J Meropol Journal: J Clin Oncol Date: 2009-08-31 Impact factor: 44.544