Cancer Research and Treatment

Original Articles

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

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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
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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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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

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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

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24,089 View
319 Download
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