The Volume-Outcome Effect Calls for Centralization of Care in Esophageal Adenocarcinoma: Results From a Large National Cancer Registry.

Authors :: Han S
Kolb JM
Hosokawa P
Friedman C
Fox C
Scott FI
Lieu CH
Vajravelu RK
McCarter M
Murphy CC
Cook MB
Gleisner A
Falk GW
Katzka DA
Wani S
Source :: The American journal of gastroenterology [Am J Gastroenterol] 2021 Apr; Vol. 116 (4), pp. 811-815.
Publication Year :: 2021
Abstract: Introduction: Using the National Cancer Database, we assessed the relationship between facility overall esophageal adenocarcinoma (EAC) case volume and survival.<br />Methods: We categorized facilities into volume quintiles based on annual EAC patient volume and performed a multivariable Cox proportional hazards regression between facility patient volume and survival.<br />Results: In a cohort of 116,675 patients, facilities with higher vs lower (≥25 vs 1-4 cases) annual EAC patient volume demonstrated improved survival (adjusted hazard ratio: 0.80. 95% confidence interval: 0.70-0.91).<br />Discussion: This robust volume-outcome effect calls for centralization of care for EAC patients at high annual case volume facilities.

Subjects :: Adenocarcinoma therapy
Aged
Esophageal Neoplasms therapy
Female
Humans
Male
Middle Aged
Morbidity trends
Survival Rate trends
United States epidemiology
Adenocarcinoma epidemiology
Delivery of Health Care organization & administration
Disease Management
Esophageal Neoplasms epidemiology
Hospitals statistics & numerical data
Population Surveillance methods
Registries

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