Survival rate in nasopharyngeal carcinoma improved by high caseload volume: A nationwide population-based study in Taiwan

Ching Chih Lee, Tze Ta Huang, Moon Sing Lee, Yu Chieh Su, Pesus Chou, Shih Hsuan Hsiao, Wen Yen Chiou, Hon Yi Lin, Sou Hsin Chien, Shih Kai Hung

研究成果: Article同行評審

23 引文 斯高帕斯(Scopus)

摘要

Background: Positive correlation between caseload and outcome has previously been validated for several procedures and cancer treatments. However, there is no information linking caseload and outcome of nasopharyngeal carcinoma (NPC) treatment. We used nationwide population-based data to examine the association between physician case volume and survival rates of patients with NPC.Methods: Between 1998 and 2000, a total of 1225 patients were identified from the Taiwan National Health Insurance Research Database. Survival analysis, the Cox proportional hazards model, and propensity score were used to assess the relationship between 10-year survival rates and physician caseloads.Results: As the caseload of individual physicians increased, unadjusted 10-year survival rates increased (p < 0.001). Using a Cox proportional hazard model, patients with NPC treated by high-volume physicians (caseload ≥ 35) had better survival rates (p = 0.001) after adjusting for comorbidities, hospital, and treatment modality. When analyzed by propensity score, the adjusted 10-year survival rate differed significantly between patients treated by high-volume physicians and patients treated by low/medium-volume physicians (75% vs. 61%; p < 0.001).Conclusions: Our data confirm a positive volume-outcome relationship for NPC. After adjusting for differences in the case mix, our analysis found treatment of NPC by high-volume physicians improved 10-year survival rate.

原文English
文章編號92
期刊Radiation Oncology
6
發行號1
DOIs
出版狀態Published - 2011 八月 11

All Science Journal Classification (ASJC) codes

  • 腫瘤科
  • 放射學、核子醫學和影像學

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