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The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106)
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
DOI: https://doi.org/10.4143/crt.2017.273
AbstractAbstract PDFSupplementary MaterialPubReaderePub
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.

Citations

Citations to this article as recorded by  
  • Accumulated Dose Deviation of Rotational and Residual Setup Errors on Nasopharyngeal Carcinoma Using MIM Treated by Helical Tomotherapy
    Wenyan Yao, Jiang Hu, Peixun Xu, Mengxue He, Yongwen Fang, Mingzhi Liu, Zongtai Li, Huilang He, Hui Liu, Wenzhao Sun, Senkui Xu
    Technology in Cancer Research & Treatment.2023;[Epub]     CrossRef
  • Systematic Review and Meta-analysis of the Association Between Radiation Therapy Treatment Volume and Patient Outcomes
    Jerry Ye Aung Kyaw, Alice Rendall, Erin F. Gillespie, Tom Roques, Laurence Court, Yolande Lievens, Alison C. Tree, Chris Frampton, Ajay Aggarwal
    International Journal of Radiation Oncology*Biology*Physics.2023; 117(5): 1063.     CrossRef
  • The Influence of Hospital Volume on the Outcomes of Nasopharyngeal, Sinonasal, and Skull-Base Tumors: A Systematic Review of the Literature
    Stephanie Flukes, Rahul K. Sharma, Shivangi Lohia, Marc A. Cohen
    Journal of Neurological Surgery Part B: Skull Base.2022; 83(03): 270.     CrossRef
  • A Comprehensive Analysis of Treatment Management and Survival Outcomes in Nasopharyngeal Carcinoma
    Khodayar Goshtasbi, Brandon M. Lehrich, Jack L. Birkenbeuel, Arash Abiri, Jeremy P. Harris, Edward C. Kuan
    Otolaryngology–Head and Neck Surgery.2021; 165(1): 93.     CrossRef
  • Hospital volume and physician volume in association with survival in patients with nasopharyngeal cancer after radiation therapy
    Tzu-Yu Lai, Chiu-Mei Yeh, Yu-Wen Hu, Chia-Jen Liu
    Radiotherapy and Oncology.2020; 151: 190.     CrossRef
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  • 5 Web of Science
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A National Study of Survival Trends and Conditional Survival in Nasopharyngeal Carcinoma: Analysis of the National Population-Based Surveillance Epidemiology and End Results Registry
Jia-Wei Lv, Xiao-Dan Huang, Yu-Pei Chen, Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Wen-Fei Li, Ai-Hua Lin, Jun Ma, Ying Sun
Cancer Res Treat. 2018;50(2):324-334.   Published online April 19, 2017
DOI: https://doi.org/10.4143/crt.2016.544
AbstractAbstract PDFPubReaderePub
Purpose
Conditional survival (CS) provides important information on survival for a period of time after diagnosis. Currently, information on CS patterns of patients with nasopharyngeal carcinoma (NPC) is lacking. We aimed to analyze survival rate over time and estimate CS for NPC patients using a national population-based registry.
Materials and Methods
Patients diagnosed with NPC between 1973 and 2007 with at least 5-year follow-up were identified from the Surveillance Epidemiology End Results registry. Traditional survival rates and crude CS estimateswere calculated using Kaplan-Meier analysis. Risk-adjusted survival curves were plotted from the proportional hazards model using the correct group prognosis method.
Results
For 7,713 patients analyzed, adjusted baseline 5-year overall survival improved significantly from 36.0% in patients diagnosed in 1973-1979, 41.7% in 1980-1989, 46.6% in 1990- 1999, to 54.7% in 2000-2007 (p < 0.01). CS analysis demonstrated that for every additional year survived, adjusted probability of surviving the next 5 years increased from 66.7% (localized), 54.0% (regional), and 35.3% (distant) at the time of diagnosis, to 83.7% (localized), 75.0% (regional), and 62.2% (distant) for patients who had survived 5 years. Adjusted 5-year CS differed among age, sex, tumor histology, ethnicity, and stage subgroups initially, but converged with time.
Conclusion
Treatment outcomes of NPC patients have greatly improved over the decades. Increases in CS become more prominent in patients with distant disease than in those with localized or regional disease as patients survive longer. CS provides more dynamic prognostic information for patients who have survived a period of time after diagnosis.

Citations

Citations to this article as recorded by  
  • A Canadian Perspective on Systemic Therapy for Recurrent or Metastatic Nasopharyngeal Carcinoma
    Anna Spreafico, Eric Winquist, Cheryl Ho, Brian O’Sullivan, Nathaniel Bouganim, Neil Chua, Sarah Doucette, Lillian L. Siu, Desiree Hao
    Current Oncology.2025; 32(1): 48.     CrossRef
  • Role of combined surgical and radiotherapy treatment in nonmetastatic WHO I nasopharyngeal carcinoma patients
    Zi-meng Wang, Si-yu Zhu, Qin Wang, Chong-yang Duan, Si-han Liu, Rui You, Ming-Yuan Chen, Pei-Yu Huang
    Acta Oto-Laryngologica.2024; 144(4): 325.     CrossRef
  • Health and Well-Being Needs Among Head and Neck Cancer Caregivers – A Systematic Review
    Sarah Benyo, Chandat Phan, Neerav Goyal
    Annals of Otology, Rhinology & Laryngology.2023; 132(4): 449.     CrossRef
  • Constructing an individualized surveillance framework for nasopharyngeal carcinoma based on a dynamic risk-adapted approach
    Tianzhu Lu, Hanchuan Xu, Wanfang Huang, Jingfeng Zong, Caizhu Pan, Chaobin Huang, Youping Xiao, Bijuan Chen, Jingao Li, Jianji Pan, Shaojun Lin, Fang Guo, Qiaojuan Guo
    Radiotherapy and Oncology.2023; 185: 109716.     CrossRef
  • Conditional survival nomogram for monitoring real-time survival of young non-metastatic nasopharyngeal cancer survivors
    Jianing Luo, Xiaonan Hu, Xiaofeng Ge
    Journal of Cancer Research and Clinical Oncology.2023; 149(12): 10181.     CrossRef
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    Oren Shechter, Daniel G. Sausen, Elisa S. Gallo, Harel Dahari, Ronen Borenstein
    International Journal of Molecular Sciences.2022; 23(22): 14389.     CrossRef
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    Nicholas Clarke, Simon Dunne, Laura Coffey, Linda Sharp, Deirdre Desmond, Jean O’Conner, Eleanor O’Sullivan, Conrad Timon, Claire Cullen, Pamela Gallagher
    Journal of Cancer Survivorship.2021; 15(6): 855.     CrossRef
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    Chen‐Fei Wu, Jia‐Wei Lv, Li Lin, Yan‐Ping Mao, Bin Deng, Wei‐Hong Zheng, Dan‐Wan Wen, Yue Chen, Jia Kou, Fo‐Ping Chen, Xing‐Li Yang, Zi‐Qi Zheng, Zhi‐Xuan Li, Si‐Si Xu, Jun Ma, Ying Sun
    Cancer Communications.2021; 41(1): 37.     CrossRef
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    Susanna Hilda Hutajulu, Daniel Howdon, Kartika Widayati Taroeno-Hariadi, Mardiah Suci Hardianti, Ibnu Purwanto, Sagung Rai Indrasari, Camelia Herdini, Bambang Hariwiyanto, Ahmad Ghozali, Henry Kusumo, Wigati Dhamiyati, Sri Retna Dwidanarti, I. Bing Tan, J
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    Qu-xia Zhang, Lv-ping Zhuang, Zhong-yang Lin
    European Archives of Oto-Rhino-Laryngology.2021; 278(12): 4955.     CrossRef
  • Characteristics of Early Death in Patients With Localized Nasopharyngeal Cancer: A Population-Based SEER Analysis
    Haiyan Chen, Zhiheng Huang, Liubo Chen, Yanlin Li, Tiehong Zhao, Qichun Wei
    Frontiers in Oncology.2021;[Epub]     CrossRef
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    The British Journal of Radiology.2019;[Epub]     CrossRef
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  • Impact of age on survival of locoregional nasopharyngeal carcinoma: An analysis of the Surveillance, Epidemiology, and End Results program database, 2004‐2013
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  • 24,089 View
  • 319 Download
  • 29 Web of Science
  • 27 Crossref
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