Hospital volume-outcome relationship in vulvar cancer treatment: a Japanese Gynecologic Oncology Group study

Guideline-Discordant Care in Early-Stage Vulvar Cancer

“…Our results are consistent with retrospective surgical and oncologic studies that demonstrate increased guideline-concordant care in high-volume compared with low-volume facilities. 12,30–33 However, the literature on the volume–access relationship in vulvar cancer is sparse and we observed that patients treated at low-volume hospitals had significantly lower odds of undergoing LN evaluation compared with those treated at intermediate and high-volume hospitals. Further research is needed to understand how access to guideline-concordant care affects survival outcomes in facilities with differing vulvar cancer case-volume.…”

Association of Hospital Surgical Volume With Survival in Early-Stage Cervical Cancer Treated With Radical Hysterectomy

“…The favorable survival effect of treating patients with cancer in referral centers has already been demonstrated for multiple cancers, 4,5 including gynecologic malignancies. 6–10 Regarding cervical cancer, previous studies suggest a possible survival benefit for patients treated in high-volume centers. 11,13,14 Lee et al 12 report results from a meta-analysis showing comparable survival outcomes in low- and high-volume hospitals, but with a higher number of patients with poorer prognosis in the latter, and conclude that the benefit of hospital volume should be investigated in well-designed studies.…”

“…2,3 The link between hospital case volume and survival improvement has been demonstrated in several cancers, including gynecologic malignancies. 4–10 Concerning cervical cancer, few studies have assessed the association between surgical volume and improved survival. 11–14…”