The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106)open access
- Authors
- Ha, Boram; Cho, Kwan Ho; Moon, Sung Ho; Lee, Chang-Geol; Keum, Ki Chang; Kim, Yeon-Sil; Wu, Hong-Gyun; Kim, Jin Ho; Ahn, Yong Chan; Oh, Dongryul; Noh, Jae Myoung; Lee, Jong Hoon; Kim, Sung Hwan; Kim, Won Taek; Oh, Young-Taek; Kang, Min Kyu; Kim, Jin Hee; Kim, Ji-Yoon; Cho, Moon-June; Kay, Chul Seoung; Choi, Jin Hwa
- Issue Date
- Jan-2019
- Publisher
- KOREAN CANCER ASSOCIATION
- Keywords
- Nasopharyngeal neoplasms; Hospital; Low- or high-volume; Treatment outcome; Three-dimensional conformal radiotherapy; Intensity-modulated radiotherapy
- Citation
- CANCER RESEARCH AND TREATMENT, v.51, no.1, pp 12 - 23
- Pages
- 12
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Volume
- 51
- Number
- 1
- Start Page
- 12
- End Page
- 23
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/45134
- DOI
- 10.4143/crt.2017.273
- ISSN
- 1598-2998
2005-9256
- Abstract
- Purpose The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC). Materials and Methods Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume >= 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. End- points were overall survival (OS) and loco-regional progression-free survival (LRPFS). Results At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0001) and not in those receiving IMRT (77.3%for HVI vs. 75.5% for LVI, p=0.170). Conclusion A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.
- Files in This Item
-
- Appears in
Collections - College of Medicine > College of Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.