Outcomes for Cervical Cancer Patients Treated With Radiation in High-Volume and Low-Volume Hospitals

Abstract

We found that the inferior survival rate of patients with cervical cancer treated at hospitals with smaller patient loads was attributable not only to a lower standard of care in such hospitals but also to the smaller patient load. Our findings indicate how treatment should be improved in hospitals with small and medium patient loads.

Neoadjuvant Chemotherapy or Endocrine Therapy for Invasive Ductal Carcinoma of the Breast With High Hormone Receptor Positivity and Human Epidermal Growth Factor Receptor 2 Negativity

“…Some studies have found that the survival rate of patients with cancer varies by hospital level. [40][41][42] We matched the cohorts on the logit of the propensity score by using calipers with widths equal to 0.2 of the standard deviation of the logit of the propensity score. 43 Matching is a common technique for selecting a control group with identical background covariates as study participants to minimize differences between individuals that the investigator believes must be controlled.…”

“…In Taiwan, hospitals are classified in various levels, such as academic hospitals (termed medical centers) with high volume and nonacademic hospitals (nonmedical centers) with low volume. Some studies have found that the survival rate of patients with cancer varies by hospital level . We matched the cohorts on the logit of the propensity score by using calipers with widths equal to 0.2 of the standard deviation of the logit of the propensity score .…”

Improved survival in cervical cancer patients receiving care at National Cancer Institute–designated cancer centers

“…14 In a subsequent study, Lin et al found that this greater use of chemotherapy and BT were major contributors to the improved survival of patients treated at large-patient-load hospitals. Larger loads were also an independent prognostic variable for survival in certain patient populations, 16 whereas another study found that hospital volume had little impact on outcome for patients with locally advanced cervical cancer. 15 Aspects of highly specialized oncologic care may be superior at centers of excellence, such as those receiving an NCI designation.…”

“…Two National Cancer Database studies of hospital volume during similar timeframes found that, although hospital volume was associated with receipt of BT, survival was not consistently affected 14,15 . Another study of the Taiwan Cancer Registry found that greater hospital patient load, as defined by the number of definitive radiotherapy procedures annually, increased use of BT, cancer‐specific survival, and overall survival 16 …”

“…14,15 Another study of the Taiwan Cancer Registry found that greater hospital patient load, as defined by the number of definitive radiotherapy procedures annually, increased use of BT, cancer-specific survival, and overall survival. 16 Cancer October 1, 2022…”