Facility volume and postoperative outcomes for malignant pleural mesothelioma: A National Cancer Data Base analysis

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Vivek VermaCharles B Simone

Abstract

This study of a large, contemporary national database evaluated postoperative outcomes and overall survival (OS) for malignant pleural mesothelioma (MPM) by facility volume. The National Cancer Database was queried for newly-diagnosed non-metastatic MPM undergoing definitive surgery (extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D)). Patients were dichotomized into those receiving therapy at a high-volume facility (HVF), defined a priori at the 90th percentile of case volume, with all others categorized as lower-volume facilities (LVFs). Statistics included multivariable logistic regression, Kaplan-Meier analysis, propensity-matching, and multivariable Cox proportional hazards modeling. Sensitivity analysis varied the dichotomized HVF-LVF cutoff and evaluated effects on postoperative outcomes and OS. Of 1307 patients, 621 (48%) were treated at LVFs and 686 (52%) at HVFs. HVFs were more often in the Middle/South Atlantic regions, and less likely in New England, South, and Midwest. Notably, 75% of procedures at HVFs were P/Ds, versus 84% at LVFs (p < 0.001). Patients treated at HVFs experienced shorter length of postoperative hospitalization (p = 0.035), lower 30-day readmission rates (4.6% vs. 6.1%, p = 0.021)...Continue Reading

Citations

Apr 24, 2019·Annals of Surgical Oncology·Vivek VermaCharles B Simone
Nov 21, 2018·The Journal of Thoracic and Cardiovascular Surgery·Vivek VermaCharles B Simone
Jul 3, 2020·Clinical Lung Cancer·Andrew R BarskyCharles B Simone
Aug 17, 2021·Cancer·Leila T TchelebiNicholas G Zaorsky

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