1. Population-based assessment of relationship between volume of practice and outcomes in head and neck cancer patients treated in a provincially coordinated radiotherapy program
- Author
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Emily Yurkowski, Mary McLay, Adrienne Stedford, Scott Matlock, Winson Y. Cheung, Robert Olson, Eric Tran, Jonn Wu, and Eric Berthelet
- Subjects
Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,medicine.medical_treatment ,Population ,Population based ,Continuous variable ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,030212 general & internal medicine ,Practice Patterns, Physicians' ,education ,Aged ,Neoplasm Staging ,education.field_of_study ,British Columbia ,Radiotherapy ,business.industry ,Significant difference ,Head and neck cancer ,Confounding ,Cancer ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Radiation therapy ,Treatment Outcome ,Oncology ,Head and Neck Neoplasms ,030220 oncology & carcinogenesis ,Female ,business - Abstract
Background and purpose Literature suggests that higher volumes of practice are associated with better survival outcomes for head and neck cancer (HNC) patients. The objective of this study was to evaluate the effect of treatment center on the overall survival (OS) and cancer-specific survival (CSS) in a provincially coordinated program. Materials and methods A population-based provincial database was used to identify all patients in BC diagnosed for the first time with a primary non-thyroid HNC and treated with radiotherapy between 2006 and 2011. Results 2330 HNC patients were included. On multivariable analysis, after controlling for age, gender, cancer stage, anatomical site, treatment and physician case frequency, OS (HR range=0.91–1.05; p =0.60–0.88) did not significantly differ by center. OS was also not significantly different for patients treated by physicians with low case frequency (HR=0.96; 0.81–1.13; p =0.60) and medium case frequency (HR=1.12; 0.84–1.49; p =0.43) in reference to high case frequency. There was no effect on OS or head and neck CSS when physician case frequency was treated as a continuous variable. Conclusions In our provincially coordinated radiotherapy program, there was no significant difference in survival between cancer centers after controlling for differences in rurality, physician case volume and other potential confounding variables.
- Published
- 2017