Hospital Service Volume as an Indicator of Treatment Patterns for Colorectal Cancer
A hospital's approach (volume of cancer treatment services provided) to treating metastatic colorectal cancer influences a patient's treatment as strongly as patient disease status. The implications of hospital-level treatment approaches across disease stages remain understudied. We sought...
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| Veröffentlicht in: | The Journal of surgical research 2024-10, Vol.302, p.685-696 |
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| container_title | The Journal of surgical research |
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| creator | Lizalek, Jason M. Eske, Jamie Thomas, Katryna K. Reames, Bradley N. Smith, Lynette Schmid, Kendra Krell, Robert W. |
| description | A hospital's approach (volume of cancer treatment services provided) to treating metastatic colorectal cancer influences a patient's treatment as strongly as patient disease status. The implications of hospital-level treatment approaches across disease stages remain understudied. We sought to determine if hospital service volume (SV) for metastatic colorectal cancer could be predictive of nonstandard treatment patterns in stages I-III colon cancer.
Using the National Cancer Database, we examined rates of nonstandard treatment patterns among patients with colon cancer between 2010 and 2017. After adjusting for clinicopathological characteristics using multivariable logistic regression, we evaluated the relationship between hospital-level SV for metastatic colorectal cancer and nonstandard treatment approaches for patients with stages I-III colon cancer.
There were significant associations between hospital-level SV for metastatic colorectal cancer and the odds of chemotherapy overtreatment among patients with stage I–III colon cancer, as well as undertreatment among patients with stages II–III disease after adjusting for hospital-, patient-, and tumor-level covariates. Patients at the highest-level SV hospitals for metastatic disease had 1.29 higher odds (95% CI = 1.18-1.41; P |
| doi_str_mv | 10.1016/j.jss.2024.07.112 |
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Using the National Cancer Database, we examined rates of nonstandard treatment patterns among patients with colon cancer between 2010 and 2017. After adjusting for clinicopathological characteristics using multivariable logistic regression, we evaluated the relationship between hospital-level SV for metastatic colorectal cancer and nonstandard treatment approaches for patients with stages I-III colon cancer.
There were significant associations between hospital-level SV for metastatic colorectal cancer and the odds of chemotherapy overtreatment among patients with stage I–III colon cancer, as well as undertreatment among patients with stages II–III disease after adjusting for hospital-, patient-, and tumor-level covariates. Patients at the highest-level SV hospitals for metastatic disease had 1.29 higher odds (95% CI = 1.18-1.41; P < 0.0001) of receiving overtreatment compared to patients from lowest SV hospitals. The odds ratio of undertreatment in highest SV compared to lowest SV was 0.64 (95% CI 0.56-0.72; P< 0.0001).
Hospital-level SV of patients with metastatic colon cancer is a significant indicator of nonstandard treatment patterns among patients with stage I–III colon cancer. Hospitals with the highest volume of cancer treatments have higher odds of providing overtreatment, while low SVs are associated with higher odds of undertreatment.
•Historic service volume (SV) of a disease state can influence future treatment intensity.•Hospital SV associated with multiagent chemotherapy use in colon cancer.•Hospital SV associated with overtreatment of stage I-III colon cancer.•Hospital SV associated with undertreatment of stage II-III colon cancer.</description><identifier>ISSN: 0022-4804</identifier><identifier>ISSN: 1095-8673</identifier><identifier>EISSN: 1095-8673</identifier><identifier>DOI: 10.1016/j.jss.2024.07.112</identifier><identifier>PMID: 39208494</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Colon cancer ; Colorectal Neoplasms - pathology ; Colorectal Neoplasms - therapy ; Databases, Factual - statistics & numerical data ; Female ; Hospitals, High-Volume - statistics & numerical data ; Hospitals, Low-Volume - statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Overtreatment ; Practice Patterns, Physicians' - statistics & numerical data ; Retrospective Studies ; Service volume ; Undertreatment ; United States - epidemiology</subject><ispartof>The Journal of surgical research, 2024-10, Vol.302, p.685-696</ispartof><rights>2024 Elsevier Inc.</rights><rights>Copyright © 2024 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c235t-a1568a3e3ea36328b6a170a21cf9ed07d8fa6c6649c6e9b2daeae9c0dc4b4a433</cites><orcidid>0009-0005-5872-2684</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022480424004967$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39208494$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lizalek, Jason M.</creatorcontrib><creatorcontrib>Eske, Jamie</creatorcontrib><creatorcontrib>Thomas, Katryna K.</creatorcontrib><creatorcontrib>Reames, Bradley N.</creatorcontrib><creatorcontrib>Smith, Lynette</creatorcontrib><creatorcontrib>Schmid, Kendra</creatorcontrib><creatorcontrib>Krell, Robert W.</creatorcontrib><title>Hospital Service Volume as an Indicator of Treatment Patterns for Colorectal Cancer</title><title>The Journal of surgical research</title><addtitle>J Surg Res</addtitle><description>A hospital's approach (volume of cancer treatment services provided) to treating metastatic colorectal cancer influences a patient's treatment as strongly as patient disease status. The implications of hospital-level treatment approaches across disease stages remain understudied. We sought to determine if hospital service volume (SV) for metastatic colorectal cancer could be predictive of nonstandard treatment patterns in stages I-III colon cancer.
Using the National Cancer Database, we examined rates of nonstandard treatment patterns among patients with colon cancer between 2010 and 2017. After adjusting for clinicopathological characteristics using multivariable logistic regression, we evaluated the relationship between hospital-level SV for metastatic colorectal cancer and nonstandard treatment approaches for patients with stages I-III colon cancer.
There were significant associations between hospital-level SV for metastatic colorectal cancer and the odds of chemotherapy overtreatment among patients with stage I–III colon cancer, as well as undertreatment among patients with stages II–III disease after adjusting for hospital-, patient-, and tumor-level covariates. Patients at the highest-level SV hospitals for metastatic disease had 1.29 higher odds (95% CI = 1.18-1.41; P < 0.0001) of receiving overtreatment compared to patients from lowest SV hospitals. The odds ratio of undertreatment in highest SV compared to lowest SV was 0.64 (95% CI 0.56-0.72; P< 0.0001).
Hospital-level SV of patients with metastatic colon cancer is a significant indicator of nonstandard treatment patterns among patients with stage I–III colon cancer. Hospitals with the highest volume of cancer treatments have higher odds of providing overtreatment, while low SVs are associated with higher odds of undertreatment.
•Historic service volume (SV) of a disease state can influence future treatment intensity.•Hospital SV associated with multiagent chemotherapy use in colon cancer.•Hospital SV associated with overtreatment of stage I-III colon cancer.•Hospital SV associated with undertreatment of stage II-III colon cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Colon cancer</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Colorectal Neoplasms - therapy</subject><subject>Databases, Factual - statistics & numerical data</subject><subject>Female</subject><subject>Hospitals, High-Volume - statistics & numerical data</subject><subject>Hospitals, Low-Volume - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Overtreatment</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Service volume</subject><subject>Undertreatment</subject><subject>United States - epidemiology</subject><issn>0022-4804</issn><issn>1095-8673</issn><issn>1095-8673</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1rGzEQhkVpaJykP6CXomMvuxl9WLuip2LaJBBIIU6uYqydBZndlSutA_n3lbGTY07DMM_7wjyMfRNQCxDmeltvc64lSF1DUwshP7GFALusWtOoz2wBIGWlW9Dn7CLnLZTdNuoLO1dWQqutXrDH25h3YcaBP1J6CZ74cxz2I3HMHCd-N3XB4xwTjz1fJ8J5pGnmf3GeKU2Z9-WyikNM5A8dK5w8pSt21uOQ6etpXrKnP7_Xq9vq_uHmbvXrvvJSLecKxdK0qEgRKqNkuzEoGkApfG-pg6ZrezTeGG29IbuRHRKS9dB5vdGolbpkP469uxT_7SnPbgzZ0zDgRHGfnQJrG2ulhYKKI-pTzDlR73YpjJhenQB3cOm2rrh0B5cOGldclsz3U_1-M1L3nniTV4CfR4DKky-Bkss-UDHQhYMP18XwQf1_0HOFPw</recordid><startdate>202410</startdate><enddate>202410</enddate><creator>Lizalek, Jason M.</creator><creator>Eske, Jamie</creator><creator>Thomas, Katryna K.</creator><creator>Reames, Bradley N.</creator><creator>Smith, Lynette</creator><creator>Schmid, Kendra</creator><creator>Krell, Robert W.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0005-5872-2684</orcidid></search><sort><creationdate>202410</creationdate><title>Hospital Service Volume as an Indicator of Treatment Patterns for Colorectal Cancer</title><author>Lizalek, Jason M. ; Eske, Jamie ; Thomas, Katryna K. ; Reames, Bradley N. ; Smith, Lynette ; Schmid, Kendra ; Krell, Robert W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c235t-a1568a3e3ea36328b6a170a21cf9ed07d8fa6c6649c6e9b2daeae9c0dc4b4a433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Colon cancer</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Colorectal Neoplasms - therapy</topic><topic>Databases, Factual - statistics & numerical data</topic><topic>Female</topic><topic>Hospitals, High-Volume - statistics & numerical data</topic><topic>Hospitals, Low-Volume - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Overtreatment</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Service volume</topic><topic>Undertreatment</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lizalek, Jason M.</creatorcontrib><creatorcontrib>Eske, Jamie</creatorcontrib><creatorcontrib>Thomas, Katryna K.</creatorcontrib><creatorcontrib>Reames, Bradley N.</creatorcontrib><creatorcontrib>Smith, Lynette</creatorcontrib><creatorcontrib>Schmid, Kendra</creatorcontrib><creatorcontrib>Krell, Robert W.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of surgical research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lizalek, Jason M.</au><au>Eske, Jamie</au><au>Thomas, Katryna K.</au><au>Reames, Bradley N.</au><au>Smith, Lynette</au><au>Schmid, Kendra</au><au>Krell, Robert W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hospital Service Volume as an Indicator of Treatment Patterns for Colorectal Cancer</atitle><jtitle>The Journal of surgical research</jtitle><addtitle>J Surg Res</addtitle><date>2024-10</date><risdate>2024</risdate><volume>302</volume><spage>685</spage><epage>696</epage><pages>685-696</pages><issn>0022-4804</issn><issn>1095-8673</issn><eissn>1095-8673</eissn><abstract>A hospital's approach (volume of cancer treatment services provided) to treating metastatic colorectal cancer influences a patient's treatment as strongly as patient disease status. The implications of hospital-level treatment approaches across disease stages remain understudied. We sought to determine if hospital service volume (SV) for metastatic colorectal cancer could be predictive of nonstandard treatment patterns in stages I-III colon cancer.
Using the National Cancer Database, we examined rates of nonstandard treatment patterns among patients with colon cancer between 2010 and 2017. After adjusting for clinicopathological characteristics using multivariable logistic regression, we evaluated the relationship between hospital-level SV for metastatic colorectal cancer and nonstandard treatment approaches for patients with stages I-III colon cancer.
There were significant associations between hospital-level SV for metastatic colorectal cancer and the odds of chemotherapy overtreatment among patients with stage I–III colon cancer, as well as undertreatment among patients with stages II–III disease after adjusting for hospital-, patient-, and tumor-level covariates. Patients at the highest-level SV hospitals for metastatic disease had 1.29 higher odds (95% CI = 1.18-1.41; P < 0.0001) of receiving overtreatment compared to patients from lowest SV hospitals. The odds ratio of undertreatment in highest SV compared to lowest SV was 0.64 (95% CI 0.56-0.72; P< 0.0001).
Hospital-level SV of patients with metastatic colon cancer is a significant indicator of nonstandard treatment patterns among patients with stage I–III colon cancer. Hospitals with the highest volume of cancer treatments have higher odds of providing overtreatment, while low SVs are associated with higher odds of undertreatment.
•Historic service volume (SV) of a disease state can influence future treatment intensity.•Hospital SV associated with multiagent chemotherapy use in colon cancer.•Hospital SV associated with overtreatment of stage I-III colon cancer.•Hospital SV associated with undertreatment of stage II-III colon cancer.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39208494</pmid><doi>10.1016/j.jss.2024.07.112</doi><tpages>12</tpages><orcidid>https://orcid.org/0009-0005-5872-2684</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Colon cancer Colorectal Neoplasms - pathology Colorectal Neoplasms - therapy Databases, Factual - statistics & numerical data Female Hospitals, High-Volume - statistics & numerical data Hospitals, Low-Volume - statistics & numerical data Humans Male Middle Aged Neoplasm Staging Overtreatment Practice Patterns, Physicians' - statistics & numerical data Retrospective Studies Service volume Undertreatment United States - epidemiology |
| title | Hospital Service Volume as an Indicator of Treatment Patterns for Colorectal Cancer |
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