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The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106)

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Author(s)
Boram HaKwan Ho ChoSung Ho MoonChang-Geol LeeKi Chang KeumYeon-Sil KimHong-Gyun WuJin Ho KimYong Chan AhnDongryul OhJae Myoung NohJong Hoon LeeSung Hwan KimWon Taek KimYoung-Taek OhMin Kyu KangJin Hee KimJi-Yoon KimMoon-June ChoChul Seoung KayJin Hwa Choi
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Cancer Research and Treatment
Issued Date
2019
Volume
51
Issue
1
Keyword
Nasopharyngeal neoplasmsHospitalLow- or high-volumeTreatment outcomeThree-dimensional conformal radiotherapyIntensity-modulated radiotherapy
Abstract
Purpose:
The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC).

Materials and Methods:
Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS).

Results:
At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170).

Conclusion:
A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine (의과대학)
Citation
Boram Ha et al. (2019). The Effect of Hospital Case Volume on Clinical Outcomes in Patients with Nasopharyngeal Carcinoma: A Multi-institutional Retrospective Analysis (KROG-1106). Cancer Research and Treatment, 51(1), 12–23. doi: 10.4143/crt.2017.273
Type
Article
ISSN
2005-9256
Source
https://www.e-crt.org/journal/view.php?number=2835
DOI
10.4143/crt.2017.273
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42122
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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