The effect of hospital volume on cancer control after radical prostatectomy.
J Urol
; 173(6): 2094-8, 2005 Jun.
Article
em En
| MEDLINE
| ID: mdl-15879850
ABSTRACT
PURPOSE:
For complex oncological procedures, hospital volume affects short and long-term patient outcome. We examined the association of hospital volume and long-term cancer control after radical prostatectomy. MATERIALS ANDMETHODS:
With a cohort study design, we used the Surveillance, Epidemiology and End Results-Medicare linked files to identify a population based sample of men with newly diagnosed prostate cancer treated primarily with radical prostatectomy. Failure of cancer control was defined as the use of postoperative medical or surgical hormone ablation or treatment with radiation therapy more than 6 months after surgery.RESULTS:
A total of 12,635 men underwent radical prostatectomy for incident prostate cancer. After adjusting for age, comorbidity, histological grade and clinical stage, the risk of adjuvant therapy was greater among those treated at low (1 to 33 cases) and medium (34 to 61 cases) volume hospitals than at very high (more than 108 cases) volume hospitals (HR 1.25, p <0.001 and HR 1.11, p =0.023 respectively).CONCLUSIONS:
Patients treated at lower volume institutions are at increased risk of initiation of subsequent adjuvant therapy with radiation therapy, medical hormone ablation or orchiectomy. Noted differences in cancer control provide additional evidence regarding issues surrounding the debate over surgical volume standards for the surgical treatment of prostate cancer.
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Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
/
Tamanho das Instituições de Saúde
/
Recidiva Local de Neoplasia
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Aged
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Urol
Ano de publicação:
2005
Tipo de documento:
Article