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World Journal of Urology

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01-09-2015 | Original Article

High hospital and surgeon volume and its impact on overall survival after radical cystectomy among patients with bladder cancer in Quebec

Authors: Fabiano Santos, Ahmed S. Zakaria, Wassim Kassouf, Simon Tanguay, Armen Aprikian

Published in: World Journal of Urology | Issue 9/2015

Abstract

Introduction and objectives

Previous studies reported improved outcomes for bladder cancer patients who had radical cystectomy (RC) performed by surgeons and hospitals with high annual RC volumes. The objective of this study was to determine the effect of high hospital and surgeon volume on overall survival after RC for bladder cancer in Quebec.

Methods

We conducted a retrospective cohort study using data of patients who underwent RC for bladder cancer from 2000 to 2009. The cohort was obtained with the linkage of two health databases: the RAMQ database (data on medical services) and the ISQ database (vital status data). Hospital and surgeon volumes were defined as the average annual number of RC performed at an institution or by surgeon, respectively, during the study period. We considered high hospital and surgeon volume those found in the third and fourth quartiles of the distribution of hospital and surgeon volumes. The effect of high hospital and surgeon volume on survival was assessed by multivariate Cox proportional hazards models.

Results

We analyzed a total of 2,778 patients who met inclusion criteria (75 % males). High hospital volume and surgeons were found to be significantly associated with improved overall survival (HR = 0.87, 95 % CI: 0.78–0.97 and HR = 0.81, 95 % CI: 0.71–0.91, respectively). The combined effect of high-volume hospital and high-volume surgeon decreased by 20 % the risk of long-term mortality (HR = 0.80, 95 % CI: 0.70–0.91).

Conclusions

Compared to low-volume providers, having RC for bladder cancer performed in high-volume hospitals or by high-volume surgeon was associated with improved overall survival.

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Title: High hospital and surgeon volume and its impact on overall survival after radical cystectomy among patients with bladder cancer in Quebec
Authors: Fabiano Santos
Ahmed S. Zakaria
Wassim Kassouf
Simon Tanguay
Armen Aprikian
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1457-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High hospital and surgeon volume and its impact on overall survival after radical cystectomy among patients with bladder cancer in Quebec

Abstract

Introduction and objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and objectives

Methods

Results

Conclusions

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