Variation in long-term oncologic outcomes by type of cancer center accreditation: An analysis of a SEER-Medicare population with pancreatic cancer.
Variation in long-term oncologic outcomes by type of cancer center accreditation: An analysis of a SEER-Medicare population with pancreatic cancer.
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DOI：
10.1016/j.amjsurg.2020.03.035
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发表时间：
2020-07
影响因子：
3
通讯作者：
Qadan M
中科院分区：
文献类型：
--
作者：
Fong ZV;Chang DC;Hur C;Jin G;Tramontano A;Sell NM;Warshaw AL;Fernandez-Del Castillo C;Ferrone CR;Lillemoe KD;Qadan M
癌症中心认证旨在识别提供高质量癌症护理的中心。这也引导患者和转介医生走向专门护理的卓越中心。我们试图检验癌症中心认证是否与改善胰腺癌患者的长期肿瘤学结果有关。使用SEER-Medicare数据库，我们确定了1996至2013年间因胰腺癌而接受胰腺切除术的患者。医院被分为三组：国家癌症研究所指定的(NCI指定的)中心，癌症委员会(CoC)认证的中心，以及“非认证”(NA)中心。多水平混合效应模型用于计算调整后的检查淋巴结数、疾病特异性生存率(DSS)和总生存率(OS)。我们在632家医院确定了5118名接受胰腺切除术的患者(41.0%的NA，49.6%的COC，9.4%的NCI)。与CoC认证或NA认证的中心相比，NCI指定的中心接受的淋巴结检查的中位数更多(分别为14个比10个比11.0个；p<；0.001)。与在COC或NA中心接受治疗的患者相比，在NCI中心接受治疗的患者有更高的5年DSS(31.2%比23.6%比23.0%；p<；0.001)。最后，与在COC或NA中心接受治疗的患者相比，在NCI中心接受治疗的患者有更高的5年OS(分别为23.5%对18.9%对17.9%；p<；0.001)。当进行调整后的分析时，这些关联仍然成立。在NCI指定的中心接受胰腺癌切除治疗的患者与改善长期肿瘤学结果有关。与NA中心相比，CoC认证的中心之间没有差异。在实施之前，必须在全球范围内对认证进行细致的验证。
Cancer center accreditation is designed to identify centers that provide high-quality cancer care. This also guides patients and referring physicians towards centers of excellence for specialized care. We sought to examine if cancer center accreditation was associated with improved long-term oncologic outcomes in patients with pancreatic adenocarcinoma. Using the SEER-Medicare database, we identified patients who underwent pancreatectomy for pancreatic adenocarcinoma from 1996 to 2013. Hospitals were categorized into three groups: National Cancer Institute-designated (NCI-designated) centers, Commission on Cancer (CoC)-accredited centers, and “non-accredited” (NA) centers. Multilevel mixed-effects models were used to calculate adjusted examined lymph nodes, disease-specific survival (DSS), and overall survival (OS). We identified 5,118 patients who underwent pancreatectomy at 632 hospitals (41.0% NA, 49.6% CoC, 9.4% NCI). NCI-designated centers had a greater median number of lymph nodes examined compared with CoC-accredited or NA centers (14 vs. 10 vs. 11.0 nodes, respectively; p < 0.001). Patients treated at NCI centers had a higher 5-year DSS compared to those treated at CoC or NA centers (31.2% vs. 23.6% vs. 23.0%, respectively; p < 0.001). Finally, patients treated at NCI centers had a higher 5-year OS compared to those treated at CoC or NA centers (23.5% vs. 18.9% vs. 17.9%, respectively; p < 0.001). The associations held true when adjusted analyses were performed. Patients with resected pancreatic cancer treated at NCI-designated centers were associated with improved long-term oncologic outcomes. There was no difference between CoC-accredited centers compared with NA centers. Meticulous validation of accreditation is warranted globally prior to implementation.
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影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
45.3
作者：
Goss, Elizabeth;Lopez, Ana Maria;Raghavan, Derek
通讯作者：
Raghavan, Derek
影响因子：
3
作者：
David EA;Cooke DT;Chen Y;Perry A;Canter RJ;Cress R
通讯作者：
Cress R
遵守国家综合癌症网络治疗指南与提高结肠癌患者生存率之间的关系。
影响因子：
6.2
作者：
Boland, Genevieve M.;Chang, George J.;Haynes, Alex B.;Chiang, Yi-Ju;Chagpar, Ryaz;Xing, Yan;Hu, Chung-Yuan;Feig, Barry W.;You, Y. Nancy;Cormier, Janice N.
通讯作者：
Cormier, Janice N.
影响因子：
120.7
作者：
Dimick, Justin B.;Nicholas, Lauren H.;Ryan, Andrew M.;Thumma, Jyothi R.;Birkmeyer, John D.
通讯作者：
Birkmeyer, John D.