TY - JOUR
T1 - The association between hospital variation in curative treatment for esophagogastric cancer and health-related quality of life and survival
AU - Vissers, Pauline A. J.
AU - Luijten, Josianne C. H. B. M.
AU - Lemmens, Valery E. P. P.
AU - van Laarhoven, Hanneke W. M.
AU - Slingerland, Marije
AU - Wijnhoven, Bas P. L.
AU - Rosman, C.
AU - Mook, Stella
AU - Heisterkamp, Joos
AU - Hendriksen, Ellen M.
AU - Gisbertz, Suzanne S.
AU - Nieuwenhuijzen, Grard A. P.
AU - Verhoeven, Rob H. A.
N1 - Funding Information: This study was funded by a grant from the Dutch Cancer Society (project number 10895 ). Data on recurrence-free survival was collected within a separate project that was funded by Bristol Myers Squibb ( CA209-77E ). The data collection for the Prospective Observational Cohort Study of Esophageal-gastric cancer Patients (POCOP) was funded by the Dutch Cancer Society (project number UVA 2014–7000 ). The funders had no role in study design, data collection and analysis, preperation of the mancuscript or decision to publish. Publisher Copyright: © 2023 The Authors
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: As previous studies showed significant hospital variation in curative treatment of esophagogastric cancer, this study assesses the association between this variation and overall, cancer-specific and recurrence-free survival, and Health-Related Quality of Life (HRQoL). Methods: Patients diagnosed with potentially curable esophageal or gastric cancer between 2015 and 2018 as registered in the Netherlands Cancer Registry were included. Data on overall survival was available for all patients, data on cancer-specific and recurrence-free survival and HRQoL was available for subgroups. Patients were classified according to diagnosis in hospitals with low, medium or high probability of treatment with curative intent (LP, MP or HP). Multivariable models were used to assess the association between LP, MP and HP hospitals and HRQoL and survival. Results: This study includes 7,199 patients with esophageal, and 2,407 with gastric cancer. Overall and cancer-specific survival was better for patients diagnosed in HP versus LP hospitals for both esophageal (HR = 0.82, 95%CI:0.77–0.88 and HR = 0.82, 95%CI:0.75–0.91, respectively), and gastric cancer (HR = 0.82, 95%CI:0.73–0.92 and HR = 0.74, 95%CI:0.64–0.87, respectively). These differences disappeared after adjustments for treatment. Recurrence-free survival was worse for gastric cancer patients diagnosed in HP hospitals (HR = 1.50, 95%CI:1.14–1.96), which disappeared after adjustment for radicality of surgery. Minor, but no clinically relevant, differences in HRQoL were observed. Conclusions: Patients diagnosed in hospitals with a high probability of treatment with curative intent have a better overall and cancer-specific but not recurrence-free survival, while minor differences in HRQoL were observed.
AB - Background: As previous studies showed significant hospital variation in curative treatment of esophagogastric cancer, this study assesses the association between this variation and overall, cancer-specific and recurrence-free survival, and Health-Related Quality of Life (HRQoL). Methods: Patients diagnosed with potentially curable esophageal or gastric cancer between 2015 and 2018 as registered in the Netherlands Cancer Registry were included. Data on overall survival was available for all patients, data on cancer-specific and recurrence-free survival and HRQoL was available for subgroups. Patients were classified according to diagnosis in hospitals with low, medium or high probability of treatment with curative intent (LP, MP or HP). Multivariable models were used to assess the association between LP, MP and HP hospitals and HRQoL and survival. Results: This study includes 7,199 patients with esophageal, and 2,407 with gastric cancer. Overall and cancer-specific survival was better for patients diagnosed in HP versus LP hospitals for both esophageal (HR = 0.82, 95%CI:0.77–0.88 and HR = 0.82, 95%CI:0.75–0.91, respectively), and gastric cancer (HR = 0.82, 95%CI:0.73–0.92 and HR = 0.74, 95%CI:0.64–0.87, respectively). These differences disappeared after adjustments for treatment. Recurrence-free survival was worse for gastric cancer patients diagnosed in HP hospitals (HR = 1.50, 95%CI:1.14–1.96), which disappeared after adjustment for radicality of surgery. Minor, but no clinically relevant, differences in HRQoL were observed. Conclusions: Patients diagnosed in hospitals with a high probability of treatment with curative intent have a better overall and cancer-specific but not recurrence-free survival, while minor differences in HRQoL were observed.
KW - Esophagogastric cancer
KW - Health-related quality of life
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85169031150&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ejso.2023.107019
DO - https://doi.org/10.1016/j.ejso.2023.107019
M3 - Article
C2 - 37659340
SN - 0748-7983
VL - 49
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 10
M1 - 107019
ER -