Processes of care and the impact of surgical volumes on cancer-specific survival: A population-based study in bladder cancer

D. Robert Siemens, William J. Mackillop, Yingwei Peng, David Berman, Ahmed Elharram, Jonathan Rhee, Christopher M. Booth

Research output: Contribution to journalArticlepeer-review

Abstract

Objective To describe the relationships between procedure volume and late survival after cystectomy for muscle-invasive bladder cancer (MIBC) and explore variables explaining any effect.

Materials and Methods Electronic records of treatment and surgical pathology reports were linked to a population-based registry to identify patients who underwent cystectomy during 1994-2008 in Ontario, Canada. Explanatory variables included adjuvant chemotherapy, lymph node dissection (LND), and margin status. A Cox proportional hazards regression model was used to explore associations between volume and cancer-specific survival (CSS) as well as overall survival.

Results The cohort included 2802 MIBC patients treated with cystectomy. High-volume hospitals were more likely to have used adjuvant chemotherapy (25% vs 18%; P

Conclusion Higher provider volume is associated with higher CSS in patients with MIBC in the general population. The volume effect was modestly mediated by the quality of LND.

Original languageEnglish (US)
Pages (from-to)1049-1056
Number of pages8
JournalUrology
Volume84
Issue number5
DOIs
StatePublished - Nov 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

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