Being treated in higher volume hospitals leads to longer progression-free survival for epithelial ovarian carcinoma patients in the Rhone-Alpes region of France

• Published in: BMC health services research Vol. 18; no. 1; pp. 3 - 11
• Main Authors: Huguet, Marius, Perrier, Lionel, Bally, Olivia, Benayoun, David, De Saint Hilaire, Pierre, Beal Ardisson, Dominique, Morelle, Magali, Havet, Nathalie, Joutard, Xavier, Meeus, Pierre, Gabelle, Philippe, Provençal, Jocelyne, Chauleur, Céline, Glehen, Olivier, Charreton, Amandine, Farsi, Fadila, Ray-Coquard, Isabelle
• Format: Journal Article Paper
• Language: English
• Published: London BioMed Central 04.01.2018; BioMed Central Ltd; Federal Reserve Bank of St. Louis; BMC
• Subjects: Aged; Ascites; Bias; Cancer therapies; Carcinoma, Ovarian Epithelial; Centralization of care; Chemotherapy; Databases, Factual; Disease; Disease management; Disease management program; Disease-Free Survival; Economics and Finance; Epithelial ovarian cancer; Female; France; Gynecology; Health Administration; Health aspects; Health Informatics; Health services; Histology; Hospital care; Hospitals; Hospitals - statistics & numerical data; Humanities and Social Sciences; Humans; Influence; Medical prognosis; Medical research; Medicine; Medicine & Public Health; Middle Aged; Mortality; Multivariate analysis; Neoplasms, Glandular and Epithelial - therapy; Nursing Research; Organization; Ovarian cancer; Ovarian Neoplasms - therapy; Ovaries; Patient outcomes; Patients; Propensity score; Public Health; Quality of life; Research Article; Retrospective Studies; Statistical analysis; structure and delivery of healthcare; Treatment Outcome; Womens health; France; Disease management program; Propensity score; France; Epithelial ovarian cancer; Centralization of care
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-017-2802-2

Background To investigate the relationship between hospital volume activities and the survival for Epithelial Ovarian Carcinoma (EOC) patients in France. Methods This retrospective study using prospectively implemented databases was conducted on an exhaustive cohort of 267 patients undergoing first-line therapy during 2012 in the Rhone-Alpes Region of France. We compared Progression-Free Survival for Epithelial Ovarian Carcinoma patients receiving first-line therapy in high- (i.e. ≥ 12 cases/year) vs. low-volume hospitals. To control for selection bias, multivariate analysis and propensity scores were used. An adjusted Kaplan-Meier estimator and a univariate Cox model weighted by the propensity score were applied. Results Patients treated in the low-volume hospitals had a probability of relapse (including death) that was almost two times (i.e. 1.94) higher than for patients treated in the high-volume hospitals ( p  < 0.001). Conclusion To our knowledge, this is the first study conducted in this setting in France. As reported in other countries, there was a significant positive association between greater volume of hospital care for EOC and patient survival. Other factors may also be important such as the quality of the surgical resection.