TY - JOUR
T1 - Hospital volume and beyond first-line palliative systemic treatment in metastatic oesophagogastric adenocarcinoma
T2 - A population-based study
AU - Dijksterhuis, Willemieke P. M.
AU - Verhoeven, Rob H. A.
AU - Pape, Marieke
AU - Slingerland, Marije
AU - Mohammad, Nadia Haj
AU - de Vos-Geelen, Judith
AU - Beerepoot, Laurens V.
AU - van Voorthuizen, Theo
AU - Creemers, Geert-Jan
AU - Lemmens, Valery E. P. P.
AU - van Oijen, Martijn G. H.
AU - van Laarhoven, Hanneke W. M.
PY - 2020/11
Y1 - 2020/11
N2 - Background: Beyond first-line palliative systemic treatment can be beneficial to selected oesophagogastric cancer patients, but experience with its administration may be limited and vary among hospitals. In a population-based study, we analysed the association between hospital systemic treatment volume and administration of beyond first-line treatment in oesophagogastric adenocarcinoma, as well as the effect on overall survival (OS).Methods: Synchronous metastatic oesophagogastric adenocarcinoma patients (2010-2017) were selected from the Netherlands Cancer Registry. Hospitals were categorised in volumes quartiles. The association between hospital systemic treatment volume and the use of beyond first-line treatment was assessed using trend and multivariable logistic regression analyses. OS was compared between hospitals with high and low beyond first-line treatment administration and treatment strategies using Kaplan-Meier curves with log-rank test and multivariable Cox proportional hazard regression.Results: Beyond first-line treatment was administered in 606 of 2,466 patients who received first-line treatment, and increased from 20% to 31% between 2010 and 2017 (P <0.001). The lowest hospital volumes were independently associated with lower beyond first-line treatment administration compared to the highest volume (OR 0.62, 95% CI 0.39-0.99; OR 0.67, 95% CI 0.48-0.95). Median OS was higher in all patients treated in hospitals with a high versus low beyond first-line treatment administration (7.9 versus 6.2 months, P <0.001). Second-line paclitaxel/ramucirumab was administered most frequently and independently associated with longer OS compared to taxane monotherapy (HR 0.74, 95% CI 0.59-0.92).Conclusion: Higher hospital volume was associated with increased beyond first-line treatment administration in oesophagogastric adenocarcinoma. Second-line paclitaxel/ramucirumab resulted in longer survival compared to taxane monotherapy. (C) 2020 The Authors. Published by Elsevier Ltd.
AB - Background: Beyond first-line palliative systemic treatment can be beneficial to selected oesophagogastric cancer patients, but experience with its administration may be limited and vary among hospitals. In a population-based study, we analysed the association between hospital systemic treatment volume and administration of beyond first-line treatment in oesophagogastric adenocarcinoma, as well as the effect on overall survival (OS).Methods: Synchronous metastatic oesophagogastric adenocarcinoma patients (2010-2017) were selected from the Netherlands Cancer Registry. Hospitals were categorised in volumes quartiles. The association between hospital systemic treatment volume and the use of beyond first-line treatment was assessed using trend and multivariable logistic regression analyses. OS was compared between hospitals with high and low beyond first-line treatment administration and treatment strategies using Kaplan-Meier curves with log-rank test and multivariable Cox proportional hazard regression.Results: Beyond first-line treatment was administered in 606 of 2,466 patients who received first-line treatment, and increased from 20% to 31% between 2010 and 2017 (P <0.001). The lowest hospital volumes were independently associated with lower beyond first-line treatment administration compared to the highest volume (OR 0.62, 95% CI 0.39-0.99; OR 0.67, 95% CI 0.48-0.95). Median OS was higher in all patients treated in hospitals with a high versus low beyond first-line treatment administration (7.9 versus 6.2 months, P <0.001). Second-line paclitaxel/ramucirumab was administered most frequently and independently associated with longer OS compared to taxane monotherapy (HR 0.74, 95% CI 0.59-0.92).Conclusion: Higher hospital volume was associated with increased beyond first-line treatment administration in oesophagogastric adenocarcinoma. Second-line paclitaxel/ramucirumab resulted in longer survival compared to taxane monotherapy. (C) 2020 The Authors. Published by Elsevier Ltd.
KW - oesophageal neoplasms
KW - Gastric neoplasms
KW - Drug therapy
KW - Palliative treatment
KW - DOUBLE-BLIND
KW - CANCER
KW - ESOPHAGEAL
KW - CHEMOTHERAPY
KW - PROBABILITY
KW - DIAGNOSIS
KW - ENGLAND
KW - LIFE
KW - CARE
U2 - 10.1016/j.ejca.2020.08.010
DO - 10.1016/j.ejca.2020.08.010
M3 - Article
C2 - 32980749
VL - 139
SP - 107
EP - 118
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
ER -