Dataset Information

Facility Volume as a Prognosticator of Survival in Locally Advanced Papillary Thyroid Cancer.

ABSTRACT:

Objectives

To evaluate the influence of facility case-volume on survival in patients with locally advanced papillary thyroid cancer (PTC), and to identify prognostic case-volume thresholds for facilities managing this patient population.

Study design

Retrospective database study.

Methods

The 2004-2017 National Cancer Database was queried for patients receiving definitive surgery for locally advanced PTC. Using K-means clustering and multivariable Cox proportional-hazards (CPH) regression, two groups with distinct spectrums of facility case-volumes were generated. Multivariable CPH regression and Kaplan-Meier analysis assessed for the influence of facility case-volume and the prognostic value of its stratification on overall survival (OS).

Results

Of 48,899 patients treated at 1304 facilities, there were 34,312 (70.2%) females and the mean age was 48.0 ± 16.0 years. Increased facility volume was significantly associated with reduced all-cause mortality (HR 0.996; 95% CI, 0.992-0.999; p = 0.008). Five facility clusters were generated, from which two distinct cohorts were identified: low (LVF; <27 cases/year) and high (HVF; ≥27 cases/year) facility case-volume. Patients at HVFs were associated with reduced mortality compared to those at LVFs (HR 0.791; 95% CI, 0.678-0.923, p = 0.003). Kaplan-Meier analysis of propensity score-matched N0 and N1 patients demonstrated higher OS in HVF cohorts (all p < 0.001).

Conclusions

Facility case-volume was an independent predictor of improved OS in locally advanced PTC, indicating a possible survival benefit at high-volume medical centers. Specifically, independent of a number of sociodemographic and clinical factors, facilities that treated ≥27 cases per year were associated with increased OS. Patients with locally advanced PTC may, therefore, benefit from referrals to higher-volume facilities.

Level of evidence

4 Laryngoscope, 133:443-450, 2023.

SUBMITTER: Abiri A

PROVIDER: S-EPMC9837308 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Facility Volume as a Prognosticator of Survival in Locally Advanced Papillary Thyroid Cancer.

Abiri Arash A Pang Jonathan C JC Roman Kelsey K Goshtasbi Khodayar K Birkenbeuel Jack L JL Kuan Edward C EC Tjoa Tjoson T Haidar Yarah M YM

The Laryngoscope 20220713 2

<h4>Objectives</h4>To evaluate the influence of facility case-volume on survival in patients with locally advanced papillary thyroid cancer (PTC), and to identify prognostic case-volume thresholds for facilities managing this patient population.<h4>Study design</h4>Retrospective database study.<h4>Methods</h4>The 2004-2017 National Cancer Database was queried for patients receiving definitive surgery for locally advanced PTC. Using K-means clustering and multivariable Cox proportional-hazards (C ...[more]

PMID: 35822421

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Dataset Information

Facility Volume as a Prognosticator of Survival in Locally Advanced Papillary Thyroid Cancer.

Objectives

Study design

Methods

Results

Conclusions

Level of evidence

Publications

Facility Volume as a Prognosticator of Survival in Locally Advanced Papillary Thyroid Cancer.

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