PMID- 29100787
OWN - NLM
STAT- MEDLINE
DCOM- 20190321
LR  - 20190321
IS  - 1879-355X (Electronic)
IS  - 0360-3016 (Linking)
VI  - 100
IP  - 2
DP  - 2018 Feb 1
TI  - Facility Volume and Survival in Nasopharyngeal Carcinoma.
PG  - 408-417
LID - S0360-3016(17)33938-X [pii]
LID - 10.1016/j.ijrobp.2017.09.038 [doi]
AB  - INTRODUCTION: Definitive treatment of nasopharyngeal carcinoma (NPC) is
      challenging owing to its rarity, complicated regional anatomy, and the intensity 
      of therapy. In contrast to other head and neck cancers, the effect of facility
      volume has not been well described for NPC. METHODS AND MATERIALS: The National
      Cancer Database was queried for patients with stage II-IVB NPC diagnosed from
      2004 to 2014 and treated with definitive radiation. Patients with incomplete
      staging, unknown receipt or timing of treatment, unknown follow-up duration,
      incomplete socioeconomic information, or treatment outside the reporting facility
      were excluded. High-volume facilities (HVFs) were defined as the top 5% of
      facilities according to the annual facility volume. RESULTS: The present analysis
      included 3941 NPC patients treated at 804 facilities with a median follow-up
      duration of 59.4 months, including 1025 patients (26.0%) treated at HVFs.
      Treatment at HVFs was associated with significantly improved overall survival
      (OS) on multivariable analysis (hazard ratio 0.79, 95% confidence interval
      0.69-0.90; P=.001). In propensity score-matched cohorts, 5-year OS was 69.1%
      versus 63.3% at HVFs versus lower volume facilities (LVFs), respectively
      (P=.003). Similar results were seen when facility volume was analyzed as a
      continuous variable. The effect of facility volume on survival varied by academic
      status (P=.002 for interaction). At academic centers, the propensity
      score-matched cohorts had 5-year OS of 71.4% compared with 62.4% (P<.001) at HVFs
      and LVFs, respectively. In contrast, the 5-year OS was 63.5% versus 67.9% (P=.68)
      in propensity score-matched patients at nonacademic HVFs and LVFs. CONCLUSIONS:
      Treatment at HVFs was associated with improved OS for patients with NPC, with the
      effect exclusively seen at academic centers.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Yoshida, Emi J
AU  - Yoshida EJ
AD  - Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles,
      California; Department of Medical Oncology, Samuel Oschin Comprehensive Cancer
      Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Luu, Michael
AU  - Luu M
AD  - Biostatistics and Bioinformatics Research Center, Cedars-Sinai Medical Center,
      Los Angeles, California.
FAU - David, John M
AU  - David JM
AD  - Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles,
      California; Department of Medical Oncology, Samuel Oschin Comprehensive Cancer
      Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Kim, Sungjin
AU  - Kim S
AD  - Department of Medical Oncology, Samuel Oschin Comprehensive Cancer Institute,
      Cedars-Sinai Medical Center, Los Angeles, California; Biostatistics and
      Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles,
      California.
FAU - Mita, Alain
AU  - Mita A
AD  - Department of Medical Oncology, Samuel Oschin Comprehensive Cancer Institute,
      Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Scher, Kevin
AU  - Scher K
AD  - Department of Medical Oncology, Samuel Oschin Comprehensive Cancer Institute,
      Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Shiao, Stephen L
AU  - Shiao SL
AD  - Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles,
      California; Department of Medical Oncology, Samuel Oschin Comprehensive Cancer
      Institute, Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Tighiouart, Mourad
AU  - Tighiouart M
AD  - Department of Medical Oncology, Samuel Oschin Comprehensive Cancer Institute,
      Cedars-Sinai Medical Center, Los Angeles, California; Biostatistics and
      Bioinformatics Research Center, Cedars-Sinai Medical Center, Los Angeles,
      California.
FAU - Lee, Nancy Y
AU  - Lee NY
AD  - Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New
      York, New York.
FAU - Ho, Allen S
AU  - Ho AS
AD  - Department of Medical Oncology, Samuel Oschin Comprehensive Cancer Institute,
      Cedars-Sinai Medical Center, Los Angeles, California; Department of Surgery,
      Cedars-Sinai Medical Center, Los Angeles, California.
FAU - Zumsteg, Zachary S
AU  - Zumsteg ZS
AD  - Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles,
      California; Department of Medical Oncology, Samuel Oschin Comprehensive Cancer
      Institute, Cedars-Sinai Medical Center, Los Angeles, California. Electronic
      address: zachary.zumsteg@cshs.org.
LA  - eng
PT  - Journal Article
DEP - 20170928
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cancer Care Facilities/*statistics & numerical data
MH  - Female
MH  - Hospitals, High-Volume/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasopharyngeal Carcinoma/*mortality/therapy
MH  - Propensity Score
EDAT- 2017/11/05 06:00
MHDA- 2019/03/22 06:00
CRDT- 2017/11/05 06:00
PHST- 2017/05/27 00:00 [received]
PHST- 2017/08/20 00:00 [revised]
PHST- 2017/09/18 00:00 [accepted]
PHST- 2017/11/05 06:00 [pubmed]
PHST- 2019/03/22 06:00 [medline]
PHST- 2017/11/05 06:00 [entrez]
AID - S0360-3016(17)33938-X [pii]
AID - 10.1016/j.ijrobp.2017.09.038 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2018 Feb 1;100(2):408-417. doi:
      10.1016/j.ijrobp.2017.09.038. Epub 2017 Sep 28.