Hospital volume and prognosis of patients with metastatic pancreatic cancer: A study using the Osaka Cancer Registry

• Published in: Journal of cancer research and clinical oncology Vol. 149; no. 14; pp. 12835 - 12841
• Main Authors: Kawamoto, Yasuharu, Ikezawa, Kenji, Tabuchi, Takahiro, Morishima, Toshitaka, Seiki, Yusuke, Watsuji, Ko, Hirao, Takeru, Higashi, Sena, Urabe, Makiko, Kai, Yugo, Takada, Ryoji, Yamai, Takuo, Mukai, Kaori, Nakabori, Tasuku, Uehara, Hiroyuki, Miyashiro, Isao, Ohkawa, Kazuyoshi
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-11-2023; Springer Nature B.V
• Subjects: Cancer Research; Chemotherapy; Hematology; Hospitals; Internal Medicine; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Multivariate analysis; Oncology; Pancreatic cancer; Patients; Prognosis; Radiation therapy; Hospital volume; Osaka Cancer Registry; Prognosis; Pancreatic cancer
• ISSN: 0171-5216; 1432-1335
• DOI: 10.1007/s00432-023-04966-x

Purpose
Pancreatic cancer (PC) has one of the worst prognoses among all solid cancers. Hospital volume has been shown to be significantly associated with outcomes in patients with PC undergoing surgery. Nonetheless, the association between hospital volume and prognosis in patients with metastatic PC remains unclear. This study aimed to examine the association between hospital volume and prognosis in patients with metastatic PC using large-scale population-based cancer registry data.
Methods
This retrospective observational study was conducted using data from the Osaka Cancer Registry database. Data of patients with metastatic PC over 10 years (2009–2018) were obtained. Hospitals were categorized into high-volume hospitals (HVHs; ≥ 240 patients diagnosed with PC for 10 years), middle-volume hospitals (MVHs; 120–239 patients diagnosed with PC for 10 years), and low-volume hospitals (LVHs; < 120 patients diagnosed with PC for 10 years). Multivariate analysis was performed to identify factors associated with overall survival (OS).
Results
The analysis included 8,929 patients with metastatic PC. Median OS was significantly more favorable in HVHs than in MVHs and LVHs. Multivariate analysis adjusted for hospital volume, age, primary tumor site, year of diagnosis, chemotherapy, and radiotherapy revealed that hospital volume was an independent factor associated with OS (HVHs vs. MVHs: hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.03–1.16;
P
 = 0.003, HVHs vs. LVHs: HR, 1.20; 95% CI, 1.13–1.27;
P
 < 0.001).
Conclusion
Hospital volume is an independent prognostic factor in patients with metastatic PC, suggesting an association between hospital volume and treatment outcomes.