TY - JOUR
T1 - Hospital volume and beyond first-line palliative systemic treatment in metastatic oesophagogastric adenocarcinoma: A population-based study
AU - Dijksterhuis, Willemieke P. M.
AU - Verhoeven, Rob H. A.
AU - Pape, Marieke
AU - Slingerland, Marije
AU - Haj Mohammad, Nadia
AU - de Vos-Geelen, Judith
AU - Beerepoot, Laurens V.
AU - van Voorthuizen, Theo
AU - Creemers, Geert-Jan
AU - Lemmens, Valery E. P. P.
AU - van Oijen, Martijn G. H.
AU - van Laarhoven, Hanneke W. M.
N1 - Funding Information: This study has been financially supported by an unrestricted research grants from Eli Lilly and Bristol-Myers Squibb . The funders of the study had no role in the study design, the collection, analysis, and interpretation of the data, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. Funding Information: RHAV reports grants from BMS and Roche. JdV reports non-financial support from BTG, a consult/advisory role for Shire, and grants and non-financial support (consultancy) from Servier. NHM reports a consult/advisory role for BMS, MSD Servier, Eli Lilly, research grant from Servier. TvV reports non-financial support from Astellas, Ipsen, Roche, and Bayer. MGHvO reports grants from Amgen, BMS, Eli Lilly, Nordic, Merck, Roche and Servier. VEPPL received educational grants and unrestricted research grants from Roche. HWMvL reports a consult/advisory role for BMS, Celgene, Lilly, Merck, and Nordic, and Servier and has received unrestricted research funding from Bayer, BMS, Celgene, Eli Lilly, Merck Serono, MSD, Nordic, Philips, Roche and Servier. The other authors declare that they have no conflicts of interest. Publisher Copyright: © 2020 Elsevier Ltd Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Background: Beyond first-line palliative systemic treatment can be beneficial to selected oesophagogastric cancer patients, but experience with its administration may be limited and vary among hospitals. In a population-based study, we analysed the association between hospital systemic treatment volume and administration of beyond first-line treatment in oesophagogastric adenocarcinoma, as well as the effect on overall survival (OS). Methods: Synchronous metastatic oesophagogastric adenocarcinoma patients (2010–2017) were selected from the Netherlands Cancer Registry. Hospitals were categorised in volumes quartiles. The association between hospital systemic treatment volume and the use of beyond first-line treatment was assessed using trend and multivariable logistic regression analyses. OS was compared between hospitals with high and low beyond first-line treatment administration and treatment strategies using Kaplan–Meier curves with log-rank test and multivariable Cox proportional hazard regression. Results: Beyond first-line treatment was administered in 606 of 2,466 patients who received first-line treatment, and increased from 20% to 31% between 2010 and 2017 (P < 0.001). The lowest hospital volumes were independently associated with lower beyond first-line treatment administration compared to the highest volume (OR 0.62, 95% CI 0.39–0.99; OR 0.67, 95% CI 0.48–0.95). Median OS was higher in all patients treated in hospitals with a high versus low beyond first-line treatment administration (7.9 versus 6.2 months, P < 0.001). Second-line paclitaxel/ramucirumab was administered most frequently and independently associated with longer OS compared to taxane monotherapy (HR 0.74, 95% CI 0.59–0.92). Conclusion: Higher hospital volume was associated with increased beyond first-line treatment administration in oesophagogastric adenocarcinoma. Second-line paclitaxel/ramucirumab resulted in longer survival compared to taxane monotherapy.
AB - Background: Beyond first-line palliative systemic treatment can be beneficial to selected oesophagogastric cancer patients, but experience with its administration may be limited and vary among hospitals. In a population-based study, we analysed the association between hospital systemic treatment volume and administration of beyond first-line treatment in oesophagogastric adenocarcinoma, as well as the effect on overall survival (OS). Methods: Synchronous metastatic oesophagogastric adenocarcinoma patients (2010–2017) were selected from the Netherlands Cancer Registry. Hospitals were categorised in volumes quartiles. The association between hospital systemic treatment volume and the use of beyond first-line treatment was assessed using trend and multivariable logistic regression analyses. OS was compared between hospitals with high and low beyond first-line treatment administration and treatment strategies using Kaplan–Meier curves with log-rank test and multivariable Cox proportional hazard regression. Results: Beyond first-line treatment was administered in 606 of 2,466 patients who received first-line treatment, and increased from 20% to 31% between 2010 and 2017 (P < 0.001). The lowest hospital volumes were independently associated with lower beyond first-line treatment administration compared to the highest volume (OR 0.62, 95% CI 0.39–0.99; OR 0.67, 95% CI 0.48–0.95). Median OS was higher in all patients treated in hospitals with a high versus low beyond first-line treatment administration (7.9 versus 6.2 months, P < 0.001). Second-line paclitaxel/ramucirumab was administered most frequently and independently associated with longer OS compared to taxane monotherapy (HR 0.74, 95% CI 0.59–0.92). Conclusion: Higher hospital volume was associated with increased beyond first-line treatment administration in oesophagogastric adenocarcinoma. Second-line paclitaxel/ramucirumab resulted in longer survival compared to taxane monotherapy.
KW - Drug therapy
KW - Gastric neoplasms
KW - Palliative treatment
KW - oesophageal neoplasms
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85091589942&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/32980749
UR - http://www.scopus.com/inward/record.url?scp=85091589942&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejca.2020.08.010
DO - https://doi.org/10.1016/j.ejca.2020.08.010
M3 - Article
C2 - 32980749
SN - 0959-8049
VL - 139
SP - 107
EP - 118
JO - European Journal of Cancer
JF - European Journal of Cancer
ER -