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Does Hospital Operative Volume Influence the Outcomes of Patients After Heated Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis?
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2024 Feb; Vol. 31 (2), pp. 1049-1057. Date of Electronic Publication: 2023 Oct 31. - Publication Year :
- 2024
-
Abstract
- Background: For some cancer operations, center volume is associated with improved patient outcomes. Whether this association is true for cytoreductive surgery/heated intraperitoneal chemotherapy (CRS/HIPEC) is unclear. Given the rapidly expanding use of CRS/HIPEC, the aim of this analysis was to determine whether a volume-outcome relationship exists for this strategy.<br />Methods: The Vizient Clinical Database® was queried for CRS/HIPEC cases from January 2020 through December 2022. Low-, medium-, and high-volume designations were made by sorting hospitals by case volume and creating equal tertiles based on total number of cases. Analysis was performed via one-way ANOVA with post-hoc Tukey test, as indicated.<br />Results: In the 36-month study period, 5165 cases were identified across 149 hospitals. Low- (n = 113), medium- (n = 25), and high-volume (n = 11) centers performed a median of 4, 21, and 47 cases per annum, respectively. Most cases were performed for appendiceal (39.3%) followed by gynecologic neoplasms (20.4%). Groups were similar with respect to age, gender, race, comorbidities, and histology. Low-volume centers were more likely to utilize the ICU post-operatively (59.6% vs. 40.5% vs. 36.3%; p = 0.02). No differences were observed in morbidity (9.4% vs. 7.1% vs. 9.0%, p = 0.71), mortality (0.9% vs. 0.6% vs. 0.7%, p = 0.93), length of stay (9.3 vs. 9.4 vs. 10 days, p = 0.83), 30-day readmissions (5.6% vs. 5.6% vs. 5.6%, p = 1.0), or total cost among groups.<br />Conclusions: No association was found between CRS/HIPEC hospital volume and post-operative outcomes. These data suggest that in academic medical centers with HIPEC programs, outcomes for commonly treated cancers are not associated with hospital volume.<br /> (© 2023. Society of Surgical Oncology.)
- Subjects :
- Humans
Female
Retrospective Studies
Hyperthermic Intraperitoneal Chemotherapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Hospitals
Cytoreduction Surgical Procedures adverse effects
Combined Modality Therapy
Survival Rate
Peritoneal Neoplasms pathology
Hyperthermia, Induced
Appendiceal Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 37906385
- Full Text :
- https://doi.org/10.1245/s10434-023-14450-y