Chen Amy Y, Pavluck Alex, Halpern Michael, Ward Elizabeth
Department of Otolaryngology, Emory University School of Medicine, Atlanta, Georgia, USA.
Head Neck. 2009 Sep;31(9):1137-43. doi: 10.1002/hed.21072.
Treatment at a high-volume facility has been associated with better outcomes in a variety of conditions. The relationship between volume and survival from laryngeal cancer has not been examined previously.
A total of 11,446 early-stage laryngeal cancer patients (1996-1998) who reported to the National Cancer Database (NCDB) were analyzed. Proportional hazards regression was used to assess the relationship between survival and treatment volume controlling for other factors associated with survival.
Treatment at low-volume facilities was associated with a significantly increased likelihood of death (hazard ratio 1.20, 95% CI 1.04-1.38). Surgical resection, as compared with radiation treatment, was associated with lower mortality (HR 0.74, 95% CI 0.69-0.80).
This study is the first to assess the relationship between survival and treatment volume in laryngeal cancer. Treatment at a high-volume facility is associated with better survival. Surgical treatment rather than radiation was also associated with better survival, although we could not control for confounders that may bias treatment selection.
在大量病例的医疗机构接受治疗与多种疾病的更好治疗效果相关。此前尚未研究过治疗量与喉癌生存率之间的关系。
对向国家癌症数据库（NCDB）报告的11446例早期喉癌患者（1996 - 1998年）进行分析。使用比例风险回归来评估生存率与治疗量之间的关系，并控制其他与生存相关的因素。
在治疗量低的机构接受治疗与死亡可能性显著增加相关（风险比1.20，95%置信区间1.04 - 1.38）。与放射治疗相比，手术切除与较低的死亡率相关（风险比0.74，95%置信区间0.69 - 0.80）。
本研究首次评估了喉癌生存率与治疗量之间的关系。在大量病例的医疗机构接受治疗与更好的生存率相关。手术治疗而非放射治疗也与更好的生存率相关，尽管我们无法控制可能影响治疗选择的混杂因素。
