Boram Ha, Kwan Ho Cho, Sung Ho Moon, Chang-Geol Lee, Ki Chang Keum, Yeon-Sil Kim, Hong-Gyun Wu, Jin Ho Kim, Yong Chan Ahn, Dongryul Oh, Jae Myoung Noh, Jong Hoon Lee, Sung Hwan Kim, Won Taek Kim, Young-Taek Oh, Min Kyu Kang, Jin Hee Kim, Ji-Yoon Kim, Moon-June Cho, Chul Seoung Kay, Jin Hwa Choi
Cancer Res Treat. 2019;51(1):12-23. Published online February 5, 2018
Purpose
The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC).
Materials and Methods
Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS).
Results
At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170).
Conclusion
A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.
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Of the remaining 85,551 cases, there were 3,231 cases (3.8%) of carcinoma in situ (morphology code/2) which were excluded. A final total of 82,320 cases were analyzed. Of the analyzed cases, 46,908 (57.0%) were males and 35,412 (43.0%) were females. The leading age groups in the order of their relative frequency were those who were 60~64 years of age (15.3%), followed by the 55~59 age group (13.8%). The six leading primary cancer sites in the order of their relative frequency were stomach (20.7%), followed by the bronchus and lung (12.1%), the liver and intrahepatic bile duct (12.0%), the colorectum (9.9%), the breast (6.4%), and then the uterine cervix (5.0%). In males, the five leading primary cancer sites were the stomach (24.2%), the liver and intrahepatic bile duct (16.3%), the bronchus and lung (16.1%), the colorectum (9.7%), and the urinary bladder (3.3%). In females, the stomach (16.2%) was the most common cancer site, followed by the breast (14.7%), the uterine cervix (11.6%), the colorectum (10.2%), and the thyroid (6.8%). Among the 1,077 cases of childhood malignancies, leukemia (35.4%), CNS tumors (16.7%), malignant lymphomas (7.0%), and sympathetic nervous system tumors (6.9%) were the most common cancer types. CONCLUSION We analyzed and report the KCCR data from 128 nationwide hospitals during 1999.
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PURPOSE Central Cancer Registry Center in Korea conducted a nation-wide hospital-based cancer registry to provide the basic data on cancer statistics. MATERIALS AND METHODS In 1998, 124 hospitals participated in the cancer registry program. All cancer registry data, submitted from the participating hospitals by diskettes during the year, were reviewed and sorted out by the committee members who were all board-qualified clinical oncologists and pathologists. To avoid duplication, every resident registration numbers were compared by the computer. Cases diagnosed by histologic examination were preferentially chosen. RESULTS Of 89,226 cases registered, 9,163 (10.3%) duplication cases were excluded. Of the remaining 80,063 cases, 3,195 cases (4.0%) of carcinoma in situ (morphology code /2) were excluded. Finally 76,868 cases were analyzed. Of the analyzed cases, 44,037 (57.3%) were male and 32,831 (42.7%) were female. The leading age groups in the order of relative frequency were 60~64 years of age (15.3%), followed by 55~59 (14.4%). The leading primary cancer sites in the order of relative frequency were stomach (20.9%), followed by liver and intrahepatic bile ducts (12.2%), bronchus and lung (11.9%), colorectum (9.6%), breast (6.1%).
In male, the leading primary cancer sites were stomach (24.4%), followed by liver and intrahepatic bile ducts (16.4%), bronchus and lung(16.0%), colorectum(9.2%) and urinary bladder (3.5%). In female, stomach (16.3%) was the most common site, followed by breast (14.1%), uterine cervix (13.0%), colorectum (10.1%) and liver and intrahepatic bile ducts (6.5%). Among the 1,190 cases of childhood malignancies, leukemia (33.4%), CNS tumor (15.7%) and sympathetic nervous system tumor (8.4%) were common. CONCLUSION We analyzed and reported the registered cancer data from 124 hospitals during 1998.
This study was performed to develop the method which could collect completely the cancer cases in Pusan Cancer Registry(PCR). The definite goals were ¨c to see the feasibility and completeness of PCR connected with Central Cancer Registry Program(CCRP), by calculating omitting rates based on utilization rate of hospitals in Pusan and registered hospitals ¨e to evaluate the possibility of generalization to other cities-Taegu, Incheun, Kwangju, Taejeon. Data sources were CCRP and claims from the Korea Medical Insurance Corporation (KMIC). l) In case of using data of the registered and unregistered hospitals in each city, the expected omitting rates were 6.2%(CCRP)-8.5%(KMIC) in Pusan, 4.7% in Taegu, 42.7% in Incheun, 26.3% in Kwangju and 13.5% in Taejeon, respectively. They was suggested to be transferred to the hospitals in other areas from doctor's offices directly. 2) In case of using data of CCR, the expected omitting rates were 9.3% in Pusan, 3.1% in Taegu, 4.2% in Incheun, 5.4% in Kwangju and 0.9% in Taejeon, respectively. 3) In case of using both two data resources -CCR and the unregistered hospitals in each city- the expected omitting rates were 1.2% in Pusan, 1.5% in Taegu, 0.0% in Incheun, 1.2% in Kwangju and 0.0% in Taejeon, respectively. Almost all patients using only the hospital in other areas visited registered hospital which have attended CCR. We could ensure about 100% completeness, combining the CCR and an active surveillance at unregistered hospitals. This model could be one of the most efficient population-based cancer registry in Korea.