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Showing content from https://pubmed.ncbi.nlm.nih.gov/33836694/ below:

The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type

doi: 10.1186/s12885-021-08129-4. The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type

Affiliations

¹ Department of Radiation Oncology, University of Nebraska Medical Center, 986861 Nebraska Medical Center, Omaha, NE, 68198-6861, USA.
² Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, USA.
³ Department of Radiation Oncology, University of Nebraska Medical Center, 986861 Nebraska Medical Center, Omaha, NE, 68198-6861, USA. clin@unmc.edu.

PMID: 33836694
PMCID: PMC8033704
DOI: 10.1186/s12885-021-08129-4

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The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type

Saber Amin et al. BMC Cancer. 2021.

doi: 10.1186/s12885-021-08129-4. Affiliations

¹ Department of Radiation Oncology, University of Nebraska Medical Center, 986861 Nebraska Medical Center, Omaha, NE, 68198-6861, USA.
² Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, USA.
³ Department of Radiation Oncology, University of Nebraska Medical Center, 986861 Nebraska Medical Center, Omaha, NE, 68198-6861, USA. clin@unmc.edu.

PMID: 33836694
PMCID: PMC8033704
DOI: 10.1186/s12885-021-08129-4

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Abstract

Background: Cancer patients with brain metastases (BMs) require multidisciplinary care, and treatment facility may play a role. This study aimed to investigate the impact of receiving treatment at academic centers on the overall survival (OS) of cancer patients with brain metastases (BMs) regardless of the primary cancer site.

Methods: This retrospective analysis of the National Cancer Database (NCDB) included patients diagnosed with non-small cell lung cancer, small-cell lung cancer, other types of lung cancer, breast cancer, melanoma, colorectal cancer, and kidney cancer and had brain metastases at the time of diagnosis. The data were extracted from the de-identified file of the NCDB, a joint program of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The Cox proportional hazard model adjusted for age at diagnosis, race, sex, place of living, income, education, primary tumor type, year of diagnosis, chemotherapy, radiation therapy (RT), and surgery of the primary cancer site was used to determine treatment facility-associated hazard ratios (HR) for survival. Overall survival was the primary outcome, which was analyzed with multivariable Cox proportional hazards regression modeling.

Results: A total of 93,633 patients were analyzed, among whom 31,579/93,633 (34.09%) were treated at academic centers. Based on the log-rank analysis, patients who received treatment at an academic facility had significantly improved OS (median OS: 6.18, CI: 6.05-6.31 vs. 4.57, CI: 4.50-4.63 months; p < 0.001) compared to patients who were treated at non-academic facilities. In the multivariable Cox regression analysis, receiving treatment at an academic facility was associated with significantly improved OS (HR: 0.85, CI: 0.84-0.87; p < 0.001) compared to non-academic facility.

Conclusions: In this extensive analysis of the NCDB, receiving treatment at academic centers was associated with significantly improved OS compared to treatment at non-academic centers.

Keywords: Brain metastases; Overall survival; Radiation therapy; Surgery; Treatment facility.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures
Fig. 1

a Patient selection diagram. b…

Fig. 1

a Patient selection diagram. b The trend of receiving treatment at academic and…

Fig. 1

a Patient selection diagram. b The trend of receiving treatment at academic and non-academic hospitals over time

Fig. 2

a Overall survival for patients…

Fig. 2

a Overall survival for patients receiving treatment at academic (AC-red) or non-academic centers…

Fig. 2

a Overall survival for patients receiving treatment at academic (AC-red) or non-academic centers (NAC-blue). b Overall survival for patients receiving treatment at Community Cancer Program (CCP-blue), Comprehensive Community Cancer Program (CCCP-red), Integrated Network Cancer Program (INCP-maroon), and academic Centers/Research (AC/R-green)