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The impact of hospital volume on racial disparities in resected rectal cancer.
- Source :
-
Journal of surgical oncology [J Surg Oncol] 2022 Mar; Vol. 125 (3), pp. 465-474. Date of Electronic Publication: 2021 Oct 27. - Publication Year :
- 2022
-
Abstract
- Background: Although high volume centers (HVC) equate to improved outcomes in rectal cancer, the impact of surgical volume related to race is less defined.<br />Methods: Patients who underwent surgical resection for stage I-III rectal adenocarcinoma were divided into cohorts based on race and hospital surgical volume. Outcomes were analyzed following 1:1 propensity-score matching using logistic, Poisson, and Cox regression analyses with marginal effects.<br />Results: Fifty-four thousand one hundred and eighty-four (91.5%) non-Black and 5043 (8.5%) Black patients underwent resection of rectal cancer. Following 1:1 matching of non-Black (N = 5026) and Black patients, 5-year overall survival (OS) of Black patients was worse (72% vs. 74.4%, average marginal effects [AME] 0.66, p = 0.04) than non-Black patients. When compared to non-Black patients managed at HVCs, Black patients had worse OS (70.1% vs. 74.7%, AME 1.55, p = 0.03), but this difference was not significant when comparing OS between non-Black and Black patients managed at HVCs (72.3% vs. 74.7%, AME 0.62, p = 0.06). Length of stay was longer among Black and HVC patients across all cohorts. There was no difference across cohorts in 90-day mortality.<br />Conclusions: Although racial disparities exist in rectal cancer, this disparity appears to be ameliorated when patients are managed at HVCs.<br /> (© 2021 Wiley Periodicals LLC.)
- Subjects :
- Adenocarcinoma ethnology
Adenocarcinoma mortality
Aged
Aged, 80 and over
Female
Hospitals, High-Volume statistics & numerical data
Hospitals, Low-Volume statistics & numerical data
Humans
Male
Middle Aged
Propensity Score
Rectal Neoplasms ethnology
Rectal Neoplasms mortality
Adenocarcinoma surgery
Black or African American statistics & numerical data
Healthcare Disparities ethnology
Proctectomy statistics & numerical data
Rectal Neoplasms surgery
White People statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1096-9098
- Volume :
- 125
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 34705272
- Full Text :
- https://doi.org/10.1002/jso.26731