Abstract
IntroductionHigh hospital case volumes are associated with improved treatment outcomes for numerous diseases. We assessed the association between academic non-profit hospital case volume and survival of adult glioblastoma patients.MethodsFrom the nationwide Finnish Cancer Registry, we identified all adult (≥ 18 years) patients with histopathological diagnoses of glioblastoma from 2000 to 2013. Five university hospitals (treating all glioblastoma patients in Finland) were classified as high-volume (one hospital), middle-volume (one hospital), and low-volume (three hospitals) based on their annual numbers of cases. We estimated one-year survival rates, estimated median overall survival times, and compared relative excess risk (RER) of death between high, middle, and low-volume hospitals.ResultsA total of 2,045 patients were included. The mean numbers of annually treated patients were 54, 40, and 17 in the high, middle, and low-volume hospitals, respectively. One-year survival rates and median survival times were higher and longer in the high-volume (39%, 9.3 months) and medium-volume (38%, 8.9 months) hospitals than in the low-volume (32%, 7.8 months) hospitals. RER of death was higher in the low-volume hospitals than in the high-volume hospital (RER = 1.19, 95% CI 1.07–1.32, p = 0.002). There was no difference in RER of death between the high-volume and medium-volume hospitals (p = 0.690).ConclusionHigher glioblastoma case volumes were associated with improved survival. Future studies should assess whether this association is due to differences in patient-specific factors or treatment quality.
Highlights
High hospital case volumes are associated with improved treatment outcomes for numerous diseases
We identified 2045 patients with primary glioblastoma diagnosed between 2000 and 2013
We found that patients with newly diagnosed glioblastoma had a 19% (7% to 32%) higher relative excess risk (RER) of death when treated in a low-volume hospital than when treated in a high-volume hospital
Summary
High hospital case volumes are associated with improved treatment outcomes for numerous diseases. We assessed the association between academic non-profit hospital case volume and survival of adult glioblastoma patients. Five university hospitals (treating all glioblastoma patients in Finland) were classified as high-volume (one hospital), middle-volume (one hospital), and low-volume (three hospitals) based on their annual numbers of cases. We estimated one-year survival rates, estimated median overall survival times, and compared relative excess risk (RER) of death between high, middle, and low-volume hospitals. Given that Finland has the largest human capital [11], one of the highest cancer survival rates [12], and one of the highest health access and quality indexes in the world [13] as well as a tax-funded universal healthcare system, Finland may be considered an optimal country for investigating any volume-outcome associations concerning cancer treatments
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have