PDF(Pubmed)
Abstract：
BACKGROUND: 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.
METHODS: From 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.
RESULTS: A 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).
CONCLUSIONS: Higher 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.
METHODS: From 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.
RESULTS: A 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).
CONCLUSIONS: Higher 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.
摘要：
背景：高住院病例量与改善多种疾病的治疗结果相关。我们评估了学术非营利性医院病例量与成年胶质母细胞瘤患者生存率之间的关系。
方法：来自全国芬兰癌症登记处，我们确定了2000年至2013年间所有经组织病理学诊断为胶质母细胞瘤的成人(≥18岁)患者.五所大学医院（在芬兰治疗所有胶质母细胞瘤患者）被归类为高容量（一家医院），中量（一家医院），以及根据其年度病例数的低数量（三家医院）。我们估计一年生存率,估计的中位总生存时间，并比较了高死亡的相对超额风险(RER)，中间,和小批量医院。
结果：共纳入2,045例患者。每年接受治疗的患者的平均人数分别为54、40和17，中间,和小批量医院，分别。在高容量人群中，一年生存率和中位生存时间更高，更长(39%，9.3个月）和中等容量（38%，8.9个月)医院比低量(32%，7.8个月）医院。低容量医院的死亡RER高于高容量医院（RER=1.19，95％CI1.07-1.32，p=0.002）。高容量医院和中等容量医院之间的死亡RER没有差异（p=0.690）。
结论：胶质母细胞瘤病例体积增大与生存率提高相关。未来的研究应该评估这种关联是否是由于患者特异性因素或治疗质量的差异。
方法：来自全国芬兰癌症登记处，我们确定了2000年至2013年间所有经组织病理学诊断为胶质母细胞瘤的成人(≥18岁)患者.五所大学医院（在芬兰治疗所有胶质母细胞瘤患者）被归类为高容量（一家医院），中量（一家医院），以及根据其年度病例数的低数量（三家医院）。我们估计一年生存率,估计的中位总生存时间，并比较了高死亡的相对超额风险(RER)，中间,和小批量医院。
结果：共纳入2,045例患者。每年接受治疗的患者的平均人数分别为54、40和17，中间,和小批量医院，分别。在高容量人群中，一年生存率和中位生存时间更高，更长(39%，9.3个月）和中等容量（38%，8.9个月)医院比低量(32%，7.8个月）医院。低容量医院的死亡RER高于高容量医院（RER=1.19，95％CI1.07-1.32，p=0.002）。高容量医院和中等容量医院之间的死亡RER没有差异（p=0.690）。
结论：胶质母细胞瘤病例体积增大与生存率提高相关。未来的研究应该评估这种关联是否是由于患者特异性因素或治疗质量的差异。
