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Title: | Association between hospital volume and outcomes in invasive ovarian cancer in Belgium: A population-based study | Authors: | Savoye, Isabelle Silversmit, Geert Bourgeois, Jolyce De Gendt, Cindy Leroy, Roos Peacock, Hanna M. Stordeur, Sabine de Sutter, Philippe Goffin, Frederic Luyckx, Mathieu ORYE, Guy Van Dam, Peter Van Gorp, Toon Verleye, Leen |
Issue Date: | 2023 | Publisher: | ELSEVIER SCI LTD | Source: | EUROPEAN JOURNAL OF CANCER, 195 (Art N° 113402) | Abstract: | Objectives: To study the association between hospital volume and outcomes in patients with invasive epithelial ovarian cancer (EOC). Methods: This study included 3988 patients diagnosed with invasive EOC between 2014 and 2018, selected from the population-based database of the Belgian Cancer Registry (BCR), and coupled with health insurance and vital status data. The associations between hospital volume and observed survival since diagnosis were assessed with Cox proportional hazard models, while volume associations with 30-day post-operative mortality and complicated recovery were evaluated using logistic regression models. Results: Treatment for EOC was very dispersed with half of the 100 centres treating fewer than six patients per year. The median survival of patients treated in centres with the highest-volume quartile was 2.5 years longer than in those with the lowest-volume quartile (4.2 years versus 1.7 years). When taking the case-mix of hospitals into account, patients treated in the lowest volume centres had a 47% higher hazard to die than patients treated in the highest volume centres (HR: 1.47, 95% CI: 1.11-1.93, p = 0.006) over the first five years after incidence. A similar association was found when focussing on the surgical volume of the hospitals and considering only operated patients with invasive EOC. Lastly, the 30-day post-operative mortality decreased significantly with increasing surgical volume. Conclusions: The large dispersion of care and expertise within Belgium and the volume-outcome associations observed in this study support the implementation of the concentration of care for patients with invasive EOC in reference centres. | Notes: | Savoye, I (corresponding author), Belgian Healthcare Knowledge Ctr, Kruidtuinlaan 55, B-1000 Brussels, Belgium. isabelle.savoye@kce.fgov.be |
Keywords: | Ovarian cancer;Reference centres;Volume-outcome analyses;Quality of care | Document URI: | http://hdl.handle.net/1942/42001 | ISSN: | 0959-8049 | e-ISSN: | 1879-0852 | DOI: | 10.1016/j.ejca.2023.113402 | ISI #: | 001110010300001 | Rights: | 2023 Elsevier Ltd. All rights reserved | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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