Does facility volume influence survival in patients with primary malignant bone tumors of the vertebral column? A comparative cohort study.

The Spine Journal : Official Journal of the North American Spine Society
Alexander L LazaridesWilliam C Eward

Abstract

Facility volume has been correlated with survival in many cancers. This relationship has not been established in primary malignant bone tumors of the vertebral column (BTVC). To investigate whether facility patient volume is associated with overall survival in patients with primary malignant BTVCs. Retrospective comparative cohort. Adult patients with chordomas, chondrosarcomas, or osteosarcomas of the mobile spine. Five-year survival. We retrospectively analyzed 733 patients with primary malignant BTVCs in the national cancer database from 2004 through 2015. Univariate and multivariate analyses were used to correlate specific outcome measures with facility volume. Volume was stratified based on cumulative martingale residuals to determine the inflection point of negative to positive impact on survival based on the patient cohort. Long-term survival was compared between patients treated at high and low volume using the Kaplan-Meier method. Only patients with malignant primary tumors were considered eligible for inclusion; patients with incomplete treatment data or benign tumors were excluded. Patients treated at high-volume centers (HVCs) were younger (p=.0003) and more likely to be insured (p<.0001). There were no significant ...Continue Reading

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