Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Topeliuksenkatu 5, P.O. Box 266, 00029, Helsinki, Finland.
Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, 00130, Helsinki, Finland.
J Neurooncol. 2020 Apr;147(2):361-370. doi: 10.1007/s11060-020-03428-5. Epub 2020 Feb 14.
High hospital case volumes are associated with improved treatment outcomes for numerous diseases. We assessed the association between academic non-profit hospital case volume and survival of adult glioblastoma patients.
From the nationwide Finnish Cancer Registry, we identified all adult (≥ 18 years) patients with histopathological diagnoses of glioblastoma from 2000 to 2013. Five university hospitals (treating all glioblastoma patients in Finland) were classified as high-volume (one hospital), middle-volume (one hospital), and low-volume (three hospitals) based on their annual numbers of cases. We estimated one-year survival rates, estimated median overall survival times, and compared relative excess risk (RER) of death between high, middle, and low-volume hospitals.
A total of 2,045 patients were included. The mean numbers of annually treated patients were 54, 40, and 17 in the high, middle, and low-volume hospitals, respectively. One-year survival rates and median survival times were higher and longer in the high-volume (39%, 9.3 months) and medium-volume (38%, 8.9 months) hospitals than in the low-volume (32%, 7.8 months) hospitals. RER of death was higher in the low-volume hospitals than in the high-volume hospital (RER = 1.19, 95% CI 1.07-1.32, p = 0.002). There was no difference in RER of death between the high-volume and medium-volume hospitals (p = 0.690).
Higher glioblastoma case volumes were associated with improved survival. Future studies should assess whether this association is due to differences in patient-specific factors or treatment quality.
大量的医院病例与许多疾病的治疗效果改善有关。我们评估了学术性非营利医院病例量与成人胶质母细胞瘤患者生存之间的关联。
我们从全国性的芬兰癌症登记处中，确定了所有 2000 年至 2013 年间经组织病理学诊断为胶质母细胞瘤的成年（≥18 岁）患者。根据年度病例数，将五所大学医院（芬兰所有胶质母细胞瘤患者的治疗医院）分为高容量（一所医院）、中容量（一所医院）和低容量（三所医院）。我们估计了一年生存率，估计了中位总生存时间，并比较了高、中、低容量医院之间的死亡相对超额风险（RER）。
共纳入 2045 例患者。高、中、低容量医院每年治疗的患者人数分别为 54、40 和 17 人。高容量（39%，9.3 个月）和中容量（38%，8.9 个月）医院的一年生存率和中位生存时间均高于低容量（32%，7.8 个月）医院。低容量医院的死亡 RER 高于高容量医院（RER=1.19，95%CI 1.07-1.32，p=0.002）。高容量医院和中容量医院之间的死亡 RER 无差异（p=0.690）。
较高的胶质母细胞瘤病例量与生存改善相关。未来的研究应评估这种关联是否归因于患者特定因素或治疗质量的差异。
