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Period-specific mea...
Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care: a nationwide population-based study
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- Liedberg, Fredrik (författare)
- Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital, Lund University, Malmö, Sweden
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- Hagberg, Oskar (författare)
- Regional Cancer Centre South, Region Skåne, Lund, Sweden,Reg Canc Ctr South, Lund, Sweden
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- Aljabery, Firas (författare)
- Linköping University,Linköpings universitet,Institutionen för klinisk och experimentell medicin,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland,Linköping University, Linköping, Sweden
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- Gardmark, T. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska Inst, Sweden,Danderyd Hospital,Karolinska Institute, Stockholm, Sweden
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- Hosseini, A. (författare)
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden,Karolinska Univ Hosp, Dept Urol, Stockholm, Sweden
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- Jahnson, Staffan (författare)
- Linköping University,Linköpings universitet,Avdelningen för Kirurgi, Ortopedi och Onkologi,Medicinska fakulteten,Region Östergötland, Urologiska kliniken i Östergötland,Linköping University, Linköping, Sweden
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- Jancke, Georg (författare)
- Lund University,Lunds universitet,Urologi - blåscancer, Malmö,Forskargrupper vid Lunds universitet,Urology - urothelial cancer, Malmö,Lund University Research Groups,Skåne University Hospital,Lund University, Malmö, Sweden
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- Jerlström, Tomas, 1969- (författare)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Urology,Orebro Univ, Sch Hlth & Med Sci, Dept Urol, Orebro, Sweden
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- Malmström, Per-Uno (författare)
- Uppsala University,Uppsala universitet,Urologkirurgi,Uppsala Univ, Sweden,Uppsala University, Uppsala, Sweden
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- Sherif, Amir (författare)
- Umeå University,Umeå universitet,Urologi och andrologi,Umea Univ, Dept Surg & Perioperat Sci Urol & Androl, Umea, Sweden,Umeå University, Umeå, Sweden
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- Ströck, Viveka (författare)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences,Department of Urology, Sahlgrenska University Hospital and, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden,Sahlgrens Univ Hosp, Dept Urol, Gothenburg, Sweden;Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Gothenburg, Sweden
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- Häggström, Christel (författare)
- Uppsala University,Umeå University,Uppsala universitet,Umeå universitet,Enheten för biobanksforskning,Department of Surgical Sciences, Uppsala University, Uppsala,Endokrinkirurgi,Umea Univ, Dept Biobank Res, Umea, Sweden,Uppsala Univ, Sweden; Umea Univ, Sweden,Umeå University, Umeå, Sweden; Uppsala University, Uppsala, Sweden
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- Holmberg, Lars (författare)
- Uppsala University,Uppsala universitet,Endokrinkirurgi,Kings Coll London, Sch Med, London, England,Uppsala Univ, Sweden; Kings Coll London, England,King's College London,Uppsala University, Uppsala, Sweden; Kings College, London, United Kingdom
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(creator_code:org_t)
- 2019-04-22
- 2019
- Engelska.
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Ingår i: Bju International. - : Wiley. - 1464-4096 .- 1464-410X. ; 53:Suppl. 221, s. 20-20
- Relaterad länk:
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http://dx.doi.org/10...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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https://urn.kb.se/re...
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https://lup.lub.lu.s...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Objective To investigate the association between hospital volume and overall survival (OS), cancer-specific survival (CSS), and quality of care of patients with bladder cancer who undergo radical cystectomy (RC), defined as the use of extended lymphadenectomy (eLND), continent reconstruction, neoadjuvant chemotherapy (NAC), and treatment delay of We used the Bladder Cancer Data Base Sweden (BladderBaSe) to study survival and indicators of perioperative quality of care in all 3172 patients who underwent RC for primary invasive bladder cancer stage T1-T3 in Sweden between 1997 and 2014. The period-specific mean annual hospital volume (PSMAV) during the 3 years preceding surgery was applied as an exposure and analysed using univariate and multivariate mixed models, adjusting for tumour and nodal stage, age, gender, comorbidity, educational level, and NAC. PSMAV was either categorised in tertiles, dichotomised (at >= 25 RCs annually), or used as a continuous variable for every increase of 10 RCs annually. Results PSMAV in the highest tertile (>= 25 RCs annually) was associated with improved OS (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.75-1.0), whereas the corresponding HR for CSS was 0.87 (95% CI 0.73-1.04). With PSMAV as a continuous variable, OS was improved for every increase of 10 RCs annually (HR 0.95, 95% CI 0.90-0.99). Moreover, higher PSMAV was associated with increased use of eLND, continent reconstruction and NAC, but also more frequently with a treatment delay of >3 months after diagnosis. Conclusions The current study supports centralisation of RC for bladder cancer, but also underpins the need for monitoring treatment delays associated with referral.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- hospital volume
- radical cystectomy
- survival
- quality of care
- #blcsm
- #BladderCancer
- bladder-cancer
- surgeon volume
- operative mortality
- impact
- survival
- morbidity
- Urology & Nephrology
- Bladder cancer
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Liedberg, Fredri ...
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Hagberg, Oskar
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Aljabery, Firas
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Gardmark, T.
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Hosseini, A.
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Jahnson, Staffan
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Jancke, Georg
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Jerlström, Tomas ...
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Malmström, Per-U ...
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Sherif, Amir
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Ströck, Viveka
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Häggström, Chris ...
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Holmberg, Lars
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