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Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study

OBJECTIVE: Associations between hospital treatment volume and survival outcomes for women with 3 types of gynecologic malignancies, and the trends and contributing factors for high-volume centers were examined. METHODS: The Japan Society of Obstetrics and Gynecology tumor registry databased retrospe...

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Autores principales: Machida, Hiroko, Matsuo, Koji, Oba, Koji, Aoki, Daisuke, Enomoto, Takayuki, Okamoto, Aikou, Katabuchi, Hidetaka, Nagase, Satoru, Mandai, Masaki, Yaegashi, Nobuo, Yamagami, Wataru, Mikami, Mikio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology; Japan Society of Gynecologic Oncology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728670/
https://www.ncbi.nlm.nih.gov/pubmed/34783206
http://dx.doi.org/10.3802/jgo.2022.33.e3
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author Machida, Hiroko
Matsuo, Koji
Oba, Koji
Aoki, Daisuke
Enomoto, Takayuki
Okamoto, Aikou
Katabuchi, Hidetaka
Nagase, Satoru
Mandai, Masaki
Yaegashi, Nobuo
Yamagami, Wataru
Mikami, Mikio
author_facet Machida, Hiroko
Matsuo, Koji
Oba, Koji
Aoki, Daisuke
Enomoto, Takayuki
Okamoto, Aikou
Katabuchi, Hidetaka
Nagase, Satoru
Mandai, Masaki
Yaegashi, Nobuo
Yamagami, Wataru
Mikami, Mikio
author_sort Machida, Hiroko
collection PubMed
description OBJECTIVE: Associations between hospital treatment volume and survival outcomes for women with 3 types of gynecologic malignancies, and the trends and contributing factors for high-volume centers were examined. METHODS: The Japan Society of Obstetrics and Gynecology tumor registry databased retrospective study examined 206,845 women with 80,741, 73,647, and 52,457 of endometrial, cervical, and ovarian tumor, respectively, who underwent primary treatment in Japan between 2004 and 2015. Associations between the annual treatment volume and overall survival (OS) for each tumor type were examined using a multivariable Cox proportional hazards model with restricted cubic splines. Institutions were categorized into 3 groups (low-, moderate-, and high-volume centers) based on hazard risks. RESULTS: Hazard ratio (HR) for OS each the 3 tumors decreased with hospital treatment volume. The cut-off points of treatment volume were defined for high- (≥50, ≥51, and ≥27), moderate- (20–49, 20–50, and 17–26), and low-volume centers (≤19, ≤19, and ≤16) by cases/year for endometrial, cervical, and ovarian tumors, respectively. Multivariate analysis revealed younger age, rare tumor histology, and initial surgical management as contributing factors for women at high-volume centers (all, p<0.001). The proportion of high-volume center treatments decreased, whereas low-volume center treatments increased (all p<0.001). Treatment at high-volume centers improved OS than that at other centers (adjusted HR [aHR]=0.83, 95% confidence interval [CI]=0.78–0.88; aHR=0.78, 95% CI=0.75–0.83; and aHR=0.90, 95% CI=0.86–0.95 for endometrial, cervical, and ovarian tumors). CONCLUSION: Hospital treatment volume impacted survival outcomes. Treatments at high-volume centers conferred survival benefits for women with gynecologic malignancies. The proportion of treatments at high-volume centers have been decreasing recently.
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spelling pubmed-87286702022-01-12 Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study Machida, Hiroko Matsuo, Koji Oba, Koji Aoki, Daisuke Enomoto, Takayuki Okamoto, Aikou Katabuchi, Hidetaka Nagase, Satoru Mandai, Masaki Yaegashi, Nobuo Yamagami, Wataru Mikami, Mikio J Gynecol Oncol Original Article OBJECTIVE: Associations between hospital treatment volume and survival outcomes for women with 3 types of gynecologic malignancies, and the trends and contributing factors for high-volume centers were examined. METHODS: The Japan Society of Obstetrics and Gynecology tumor registry databased retrospective study examined 206,845 women with 80,741, 73,647, and 52,457 of endometrial, cervical, and ovarian tumor, respectively, who underwent primary treatment in Japan between 2004 and 2015. Associations between the annual treatment volume and overall survival (OS) for each tumor type were examined using a multivariable Cox proportional hazards model with restricted cubic splines. Institutions were categorized into 3 groups (low-, moderate-, and high-volume centers) based on hazard risks. RESULTS: Hazard ratio (HR) for OS each the 3 tumors decreased with hospital treatment volume. The cut-off points of treatment volume were defined for high- (≥50, ≥51, and ≥27), moderate- (20–49, 20–50, and 17–26), and low-volume centers (≤19, ≤19, and ≤16) by cases/year for endometrial, cervical, and ovarian tumors, respectively. Multivariate analysis revealed younger age, rare tumor histology, and initial surgical management as contributing factors for women at high-volume centers (all, p<0.001). The proportion of high-volume center treatments decreased, whereas low-volume center treatments increased (all p<0.001). Treatment at high-volume centers improved OS than that at other centers (adjusted HR [aHR]=0.83, 95% confidence interval [CI]=0.78–0.88; aHR=0.78, 95% CI=0.75–0.83; and aHR=0.90, 95% CI=0.86–0.95 for endometrial, cervical, and ovarian tumors). CONCLUSION: Hospital treatment volume impacted survival outcomes. Treatments at high-volume centers conferred survival benefits for women with gynecologic malignancies. The proportion of treatments at high-volume centers have been decreasing recently. Asian Society of Gynecologic Oncology; Korean Society of Gynecologic Oncology; Japan Society of Gynecologic Oncology 2021-11-01 /pmc/articles/PMC8728670/ /pubmed/34783206 http://dx.doi.org/10.3802/jgo.2022.33.e3 Text en Copyright © 2021. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology, and Japan Society of Gynecologic Oncology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Machida, Hiroko
Matsuo, Koji
Oba, Koji
Aoki, Daisuke
Enomoto, Takayuki
Okamoto, Aikou
Katabuchi, Hidetaka
Nagase, Satoru
Mandai, Masaki
Yaegashi, Nobuo
Yamagami, Wataru
Mikami, Mikio
Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title_full Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title_fullStr Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title_full_unstemmed Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title_short Association between hospital treatment volume and survival of women with gynecologic malignancy in Japan: a JSOG tumor registry-based data extraction study
title_sort association between hospital treatment volume and survival of women with gynecologic malignancy in japan: a jsog tumor registry-based data extraction study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8728670/
https://www.ncbi.nlm.nih.gov/pubmed/34783206
http://dx.doi.org/10.3802/jgo.2022.33.e3
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