Will patients benefit from regionalization of gynecologic cancer care?

Kathleen F. Brookfield, Michael C. Cheung, Relin Yang, Margaret M. Byrne, Leonidas Koniaris

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. Methods: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. Results:Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%), cervical cancer (20.8%), vulvar cancer (4.6%), and uterine sarcoma (0.5%). By univariate analysis, although patients treated at high volume centers (HVC) were significantly younger, they benefited from an improved short-term (30-day and/or 90-day) survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA), however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF) or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p

Original languageEnglish (US)
Article numbere4049
JournalPLoS One
Volume4
Issue number1
DOIs
StatePublished - Jan 6 2009
Externally publishedYes

Fingerprint

Teaching
Patient treatment
neoplasms
Tumors
Neoplasms
sarcoma
multivariate analysis
Uterine Cervical Neoplasms
Sarcoma
Ovarian Neoplasms
Multivariate Analysis
uterine cervical neoplasms
Vulvar Neoplasms
ovarian neoplasms
Survival
carcinoma
Endometrial Neoplasms
Information Systems
Carcinoma
methodology

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Will patients benefit from regionalization of gynecologic cancer care? / Brookfield, Kathleen F.; Cheung, Michael C.; Yang, Relin; Byrne, Margaret M.; Koniaris, Leonidas.

In: PLoS One, Vol. 4, No. 1, e4049, 06.01.2009.

Research output: Contribution to journalArticle

Brookfield, Kathleen F. ; Cheung, Michael C. ; Yang, Relin ; Byrne, Margaret M. ; Koniaris, Leonidas. / Will patients benefit from regionalization of gynecologic cancer care?. In: PLoS One. 2009 ; Vol. 4, No. 1.
@article{4ecadc6e4c5b4ec9877081dac93c2c8c,
title = "Will patients benefit from regionalization of gynecologic cancer care?",
abstract = "Objective: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. Methods: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. Results:Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2{\%} of the entire cohort, followed by ovarian cancer (30.9{\%}), cervical cancer (20.8{\%}), vulvar cancer (4.6{\%}), and uterine sarcoma (0.5{\%}). By univariate analysis, although patients treated at high volume centers (HVC) were significantly younger, they benefited from an improved short-term (30-day and/or 90-day) survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA), however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF) or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p",
author = "Brookfield, {Kathleen F.} and Cheung, {Michael C.} and Relin Yang and Byrne, {Margaret M.} and Leonidas Koniaris",
year = "2009",
month = "1",
day = "6",
doi = "10.1371/journal.pone.0004049",
language = "English (US)",
volume = "4",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "1",

}

TY - JOUR

T1 - Will patients benefit from regionalization of gynecologic cancer care?

AU - Brookfield, Kathleen F.

AU - Cheung, Michael C.

AU - Yang, Relin

AU - Byrne, Margaret M.

AU - Koniaris, Leonidas

PY - 2009/1/6

Y1 - 2009/1/6

N2 - Objective: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. Methods: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. Results:Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%), cervical cancer (20.8%), vulvar cancer (4.6%), and uterine sarcoma (0.5%). By univariate analysis, although patients treated at high volume centers (HVC) were significantly younger, they benefited from an improved short-term (30-day and/or 90-day) survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA), however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF) or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p

AB - Objective: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. Methods: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. Results:Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%), cervical cancer (20.8%), vulvar cancer (4.6%), and uterine sarcoma (0.5%). By univariate analysis, although patients treated at high volume centers (HVC) were significantly younger, they benefited from an improved short-term (30-day and/or 90-day) survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA), however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF) or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p

UR - http://www.scopus.com/inward/record.url?scp=59249109543&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=59249109543&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0004049

DO - 10.1371/journal.pone.0004049

M3 - Article

VL - 4

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 1

M1 - e4049

ER -