Faculty Collaboration Database

Comparison of overall survival in gallbladder carcinoma at academic versus community cancer centers: An analysis of the National Cancer Data Base. J Surg Oncol 2020 Aug;122(2):176-182

Date

05/10/2020

Pubmed ID

32383268

DOI

10.1002/jso.25907

Scopus ID

2-s2.0-85085151262 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND AND OBJECTIVES: Gallbladder carcinoma (GBC) has a poor prognosis. Studies demonstrated that teaching facilities may provide a lower risk of mortality in patients undergoing pancreatic and colon resection vs nonteaching facilities. We hypothesized that survival rates are higher in academic cancer centers (ACCs) vs community cancer centers (CCCs).

METHODS: Patients with all stages of GBC were identified from the National Cancer Database (2007-2012). Propensity score matching adjusted for selection bias. Descriptive statistics were calculated for all variables. Overall survival (OS) was compared by facility type (ACC vs CCC) and case volume (low vs high) via multivariable Cox proportional hazards regression.

RESULTS: A total of 7967 patients met the inclusion criteria. Following propensity matching, 2801 patients were analyzed from each facility type. Median OS following surgery was higher for ACC (20.99 months, 95% confidence interval [CI], 19.61-22.64, P = .002) than CCC (17.68 months, 95% CI, 16.46-19.25). Following Cox modeling, GBC treatment at ACCs was a protective factor for OS (adjusted hazard ratio 0.876, 95% CI, 0.801-0.958, P = .004).

DISCUSSION: GBC treatment at ACCs is an independent predictor of OS. High volume ACCs are associated with improved OS compared with low volume ACCs. The site of care and case volume in ACCs may contribute to improved survival outcomes.

Author List

Liu C, Rein L, Clarke C, Mogal H, Tsai S, Christians KK, Gamblin TC

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Callisia N. Clarke MD Chief, Associate Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin
Lisa E. Rein Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Aged
Cancer Care Facilities
Female
Gallbladder Neoplasms
Hospitals, Community
Humans
Male
Middle Aged
Neoplasm Staging
Propensity Score
Proportional Hazards Models
Survival Analysis
United States