Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands

J. van Breeschoten; A.J.M. van den Eertwegh; L.C. de Wreede; D.L. Hilarius; E.W. van Zwet; J.B. Haanen; C.U. Blank; M.J.B. Aarts; F.W.P.J. van den Berkmortel; J.W.B. de Groot; G.A.P. Hospers; E. Kapiteijn; D. Piersma; R.S. van Rijn; M.A.M. Stevense-den Boer; A.A.M. van der Veldt; G. Vreugdenhil; M.J. Boers-Sonderen; K.P.M. Suijkerbuijk; M.W.J.M. Wouters

doi:10.3390/cancers13205077

Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands

J. van Breeschoten, A.J.M. van den Eertwegh, L.C. de Wreede, D.L. Hilarius, E.W. van Zwet, J.B. Haanen, C.U. Blank, M.J.B. Aarts, F.W.P.J. van den Berkmortel, J.W.B. de Groot, G.A.P. Hospers, E. Kapiteijn, D. Piersma, R.S. van Rijn, M.A.M. Stevense-den Boer, A.A.M. van der Veldt, G. Vreugdenhil, M.J. Boers-Sonderen, K.P.M. Suijkerbuijk, M.W.J.M. Wouters^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Simple Summary:& nbsp;The survival of advanced melanoma patients has improved significantly over the last decade due to the introduction of new systemic therapies. It is unknown whether survival outcomes of advanced melanoma patients differ between melanoma centers in the Netherlands. This research aimed to assess center variation in treatments and 2-year survival probabilities of advanced melanoma patients diagnosed between 2013 and 2017 in the Netherlands. Significant center variation in 2-year survival probabilities of patients diagnosed in 2014-2015 was observed after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. This study shows the added value of quality monitoring with a national registry that enables the study of variation between centers.</p><br></p>Background: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands. Methods: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared. Results: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. Conclusion: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.</p>

Original language	English
Article number	5077
Number of pages	12
Journal	Cancers
Volume	13
Issue number	20
DOIs	https://doi.org/10.3390/cancers13205077
Publication status	Published - 1 Oct 2021

Keywords

advanced melanoma
survival
center variation
METASTATIC MELANOMA
POOLED ANALYSIS
DABRAFENIB
MULTICENTER
VEMURAFENIB
IMPACT

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van Breeschoten, J., van den Eertwegh, A. J. M., de Wreede, L. C., Hilarius, D. L., van Zwet, E. W., Haanen, J. B., Blank, C. U., Aarts, M. J. B., van den Berkmortel, F. W. P. J., de Groot, J. W. B., Hospers, G. A. P., Kapiteijn, E., Piersma, D., van Rijn, R. S., Stevense-den Boer, M. A. M., van der Veldt, A. A. M., Vreugdenhil, G., Boers-Sonderen, M. J., Suijkerbuijk, K. P. M., & Wouters, M. W. J. M. (2021). Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands. Cancers, 13(20), Article 5077. https://doi.org/10.3390/cancers13205077

@article{2301890bc1cf4831a3df308628500e1c,

title = "Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands",

abstract = "Simple Summary:& nbsp;The survival of advanced melanoma patients has improved significantly over the last decade due to the introduction of new systemic therapies. It is unknown whether survival outcomes of advanced melanoma patients differ between melanoma centers in the Netherlands. This research aimed to assess center variation in treatments and 2-year survival probabilities of advanced melanoma patients diagnosed between 2013 and 2017 in the Netherlands. Significant center variation in 2-year survival probabilities of patients diagnosed in 2014-2015 was observed after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. This study shows the added value of quality monitoring with a national registry that enables the study of variation between centers.Background: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands. Methods: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared. Results: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. Conclusion: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.",

keywords = "advanced melanoma, survival, center variation, METASTATIC MELANOMA, POOLED ANALYSIS, DABRAFENIB, MULTICENTER, VEMURAFENIB, IMPACT",

author = "{van Breeschoten}, J. and {van den Eertwegh}, A.J.M. and {de Wreede}, L.C. and D.L. Hilarius and {van Zwet}, E.W. and J.B. Haanen and C.U. Blank and M.J.B. Aarts and {van den Berkmortel}, F.W.P.J. and {de Groot}, J.W.B. and G.A.P. Hospers and E. Kapiteijn and D. Piersma and {van Rijn}, R.S. and {Stevense-den Boer}, M.A.M. and {van der Veldt}, A.A.M. and G. Vreugdenhil and M.J. Boers-Sonderen and K.P.M. Suijkerbuijk and M.W.J.M. Wouters",

note = "Funding Information: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start‐up grant from governmental organization The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Funding Information: Funding: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Au‐ diting foundation received a start‐up grant from governmental organization The Netherlands Or‐ ganization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = oct,

day = "1",

doi = "10.3390/cancers13205077",

language = "English",

volume = "13",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "20",

}

van Breeschoten, J, van den Eertwegh, AJM, de Wreede, LC, Hilarius, DL, van Zwet, EW, Haanen, JB, Blank, CU, Aarts, MJB, van den Berkmortel, FWPJ, de Groot, JWB, Hospers, GAP, Kapiteijn, E, Piersma, D, van Rijn, RS, Stevense-den Boer, MAM, van der Veldt, AAM, Vreugdenhil, G, Boers-Sonderen, MJ, Suijkerbuijk, KPM & Wouters, MWJM 2021, 'Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands', Cancers, vol. 13, no. 20, 5077. https://doi.org/10.3390/cancers13205077

TY - JOUR

T1 - Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma Patients: Nationwide Quality Assurance in The Netherlands

AU - van Breeschoten, J.

AU - van den Eertwegh, A.J.M.

AU - de Wreede, L.C.

AU - Hilarius, D.L.

AU - van Zwet, E.W.

AU - Haanen, J.B.

AU - Blank, C.U.

AU - Aarts, M.J.B.

AU - van den Berkmortel, F.W.P.J.

AU - de Groot, J.W.B.

AU - Hospers, G.A.P.

AU - Kapiteijn, E.

AU - Piersma, D.

AU - van Rijn, R.S.

AU - Stevense-den Boer, M.A.M.

AU - van der Veldt, A.A.M.

AU - Vreugdenhil, G.

AU - Boers-Sonderen, M.J.

AU - Suijkerbuijk, K.P.M.

AU - Wouters, M.W.J.M.

N1 - Funding Information: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start‐up grant from governmental organization The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Funding Information: Funding: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Au‐ diting foundation received a start‐up grant from governmental organization The Netherlands Or‐ ganization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/10/1

Y1 - 2021/10/1

N2 - Simple Summary:& nbsp;The survival of advanced melanoma patients has improved significantly over the last decade due to the introduction of new systemic therapies. It is unknown whether survival outcomes of advanced melanoma patients differ between melanoma centers in the Netherlands. This research aimed to assess center variation in treatments and 2-year survival probabilities of advanced melanoma patients diagnosed between 2013 and 2017 in the Netherlands. Significant center variation in 2-year survival probabilities of patients diagnosed in 2014-2015 was observed after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. This study shows the added value of quality monitoring with a national registry that enables the study of variation between centers.Background: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands. Methods: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared. Results: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. Conclusion: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.

AB - Simple Summary:& nbsp;The survival of advanced melanoma patients has improved significantly over the last decade due to the introduction of new systemic therapies. It is unknown whether survival outcomes of advanced melanoma patients differ between melanoma centers in the Netherlands. This research aimed to assess center variation in treatments and 2-year survival probabilities of advanced melanoma patients diagnosed between 2013 and 2017 in the Netherlands. Significant center variation in 2-year survival probabilities of patients diagnosed in 2014-2015 was observed after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. This study shows the added value of quality monitoring with a national registry that enables the study of variation between centers.Background: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands. Methods: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared. Results: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers. Conclusion: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.

KW - advanced melanoma

KW - survival

KW - center variation

KW - METASTATIC MELANOMA

KW - POOLED ANALYSIS

KW - DABRAFENIB

KW - MULTICENTER

KW - VEMURAFENIB

KW - IMPACT

U2 - 10.3390/cancers13205077

DO - 10.3390/cancers13205077

M3 - Article

C2 - 34680228

SN - 2072-6694

VL - 13

JO - Cancers

JF - Cancers

IS - 20

M1 - 5077

ER -