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

Am J Gastroenterol. 2021 Apr;116(4):811-815. doi: 10.14309/ajg.0000000000001046.

Abstract

Introduction: Using the National Cancer Database, we assessed the relationship between facility overall esophageal adenocarcinoma (EAC) case volume and survival.

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.

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).

Discussion: This robust volume-outcome effect calls for centralization of care for EAC patients at high annual case volume facilities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Supplementary concepts

  • Adenocarcinoma Of Esophagus