1. Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients
- Author
-
Michel W.J.M. Wouters, Marion Stevense, Ellen Kapiteijn, Christian U. Blank, Karijn P M Suijkerbuijk, Astrid Aplonia Maria Van Der Veldt, Geke A. P. Hospers, Djura Piersma, Rozemarijn S. van Rijn, Alfonsus J. M. van den Eertwegh, Gerard Vreugdenhil, Maureen J.B. Aarts, Liesbeth C. de Wreede, Jesper van Breeschoten, Erik W. van Zwet, John B. A. G. Haanen, Jan Willem B. de Groot, Franchette W P J van den Berkmortel, Marye Boers-Sonderen, Doranne L. Hilarius, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Internal medicine, Medical oncology, AII - Cancer immunology, CCA - Cancer Treatment and quality of life, Obstetrics and gynaecology, Medical Oncology, Radiology & Nuclear Medicine, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Interne Geneeskunde, and MUMC+: MA Medische Oncologie (9)
- Subjects
Oncology ,advanced melanoma ,Cancer Research ,medicine.medical_specialty ,Metastatic melanoma ,IMPACT ,MULTICENTER ,survival ,VEMURAFENIB ,Article ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,POOLED ANALYSIS ,All institutes and research themes of the Radboud University Medical Center ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,METASTATIC MELANOMA ,Quality of care ,RC254-282 ,Advanced melanoma ,business.industry ,center variation ,Melanoma ,Significant difference ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Cancer ,medicine.disease ,Random effects model ,DABRAFENIB ,Stage iv melanoma ,business ,Quality assurance - Abstract
Simple Summary: The survival of advanced melanoma patients has improved significantly over the last decade due to the introduction of new systemic therapies. It is unknown whether survival outcomes of advanced melanoma patients differ between melanoma centers in the Netherlands. This research aimed to assess center variation in treatments and 2-year survival probabilities of advanced melanoma patients diagnosed between 2013 and 2017 in the Netherlands. Significant center variation in 2-year survival probabilities of patients diagnosed in 2014-2015 was observed after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. This study shows the added value of quality monitoring with a national registry that enables the study of variation between centers.Background: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands. Methods: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared. Results: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. Conclusion: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.
- Published
- 2021