The Volume-Outcome Effect Calls for Centralization of Care in Esophageal Adenocarcinoma: Results From a Large National Cancer Registry

Samuel Han, Jennifer M. Kolb, Patrick Hosokawa, Chloe Friedman, Charlie Fox, Frank I. Scott, Christopher H. Lieu, Ravy K. Vajravelu, Martin McCarter, Caitlin C. Murphy, Michael B. Cook, Ana Gleisner, Gary W. Falk, David A. Katzka, Sachin Wani

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: Using the National Cancer Database, we assessed the relationship between facility overall esophageal adenocarcinoma (EAC) case volume and survival. METHODS: We categorized facilities into volume quintiles based on annual EAC patient volume and performed a multivariable Cox proportional hazards regression between facility patient volume and survival. RESULTS: In a cohort of 116,675 patients, facilities with higher vs lower (≥25 vs 1-4 cases) annual EAC patient volume demonstrated improved survival (adjusted hazard ratio: 0.80. 95% confidence interval: 0.70-0.91). DISCUSSION: This robust volume-outcome effect calls for centralization of care for EAC patients at high annual case volume facilities.

Original languageEnglish (US)
Pages (from-to)811-815
Number of pages5
JournalThe American Journal of Gastroenterology
Volume116
Issue number4
DOIs
StatePublished - Apr 1 2021

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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