TY - JOUR
T1 - Effect of Hospital Cancer Designation on use of Multimodal Therapy and Survival of Metastatic Colorectal Cancer
T2 - A State-Wide Analysis
AU - Meier, Jennie
AU - Murimwa, Gilbert
AU - Nehrubabu, Mithin
AU - DiMartino, Lisa
AU - Singal, Amit G.
AU - Karagkounis, Georgios
AU - Yopp, Adam
AU - Zeh, Herbert J.
AU - Polanco, Patricio M.
N1 - Publisher Copyright:
© Society of Surgical Oncology 2024.
PY - 2024/4
Y1 - 2024/4
N2 - Background: Stage IV colorectal cancer (CRC) often requires multidisciplinary approach. However, multimodal treatment options (receipt of > 1 type of treatment) may not be uniformly delivered across health systems. We characterized the association between center-level cancer center designation and receipt of multimodal treatment and survival. Methods: The Texas Cancer Registry was used to identify patients diagnosed with stage IV CRC from 2004–2017. We identified those who received care at either: a National Cancer Institute-designated (NCI-D), an American College of Surgeons-Commission on Cancer-designated (ACS-D), or an undesignated facility. We used multivariable logistic regression and Cox regression for analysis to assess receipt of one or more treatment modality and 5-year overall survival. Results: Of 19,355 patients with stage IV CRC, 2955 (15%) received care at an NCI-D facility and 5871 (30%) received multimodal therapy. Both NCI-D (odds ratio [OR] 1.64; 95% confidence interval [CI] 1.49–1.81) and ACS-D (OR 1.37; 95% CI 1.27–1.48) were associated with increased likelihood of multimodal therapy compared with undesignated centers. NCI-D also was associated with significantly improved survival (hazard ratio [HR] 0.74; 95% CI 0.70–0.78), although ACS-D was associated with a modest improvement in survival (HR 0.95; 95% CI 0.92–0.99). Receipt of multimodal therapy was strongly associated with improved survival (HR 0.61; 95% CI 0.59–0.63). Conclusions: In patients with stage IV CRC, treatment at ACS-D and NCI-D facilities was associated with increased use of multimodality therapy and improved survival. However, only a small proportion of patients have access to these specialized centers, highlighting a need for expanded access to multimodal therapies at other centers.
AB - Background: Stage IV colorectal cancer (CRC) often requires multidisciplinary approach. However, multimodal treatment options (receipt of > 1 type of treatment) may not be uniformly delivered across health systems. We characterized the association between center-level cancer center designation and receipt of multimodal treatment and survival. Methods: The Texas Cancer Registry was used to identify patients diagnosed with stage IV CRC from 2004–2017. We identified those who received care at either: a National Cancer Institute-designated (NCI-D), an American College of Surgeons-Commission on Cancer-designated (ACS-D), or an undesignated facility. We used multivariable logistic regression and Cox regression for analysis to assess receipt of one or more treatment modality and 5-year overall survival. Results: Of 19,355 patients with stage IV CRC, 2955 (15%) received care at an NCI-D facility and 5871 (30%) received multimodal therapy. Both NCI-D (odds ratio [OR] 1.64; 95% confidence interval [CI] 1.49–1.81) and ACS-D (OR 1.37; 95% CI 1.27–1.48) were associated with increased likelihood of multimodal therapy compared with undesignated centers. NCI-D also was associated with significantly improved survival (hazard ratio [HR] 0.74; 95% CI 0.70–0.78), although ACS-D was associated with a modest improvement in survival (HR 0.95; 95% CI 0.92–0.99). Receipt of multimodal therapy was strongly associated with improved survival (HR 0.61; 95% CI 0.59–0.63). Conclusions: In patients with stage IV CRC, treatment at ACS-D and NCI-D facilities was associated with increased use of multimodality therapy and improved survival. However, only a small proportion of patients have access to these specialized centers, highlighting a need for expanded access to multimodal therapies at other centers.
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U2 - 10.1245/s10434-023-14859-5
DO - 10.1245/s10434-023-14859-5
M3 - Article
C2 - 38245645
AN - SCOPUS:85182818628
SN - 1068-9265
VL - 31
SP - 2591
EP - 2597
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 4
ER -