A recent study suggested a possible link between lower mortality for patients with classical Hodgkin lymphoma (cHL) and patient volume at care facilities where patients with cHL are treated. The study results were published in Cancer.
In this analysis of National Cancer Database patient records from 2003 through 2014, 1310 facilities comprising 47,633 patients were divided into quartiles based on annual numbers of patients with Hodgkin lymphoma seen. Using Cox regression analysis, the researchers explored whether there was a relationship between facility patient volume and outcomes for patients with cHL.
Facilities in this study showed a median volume of 2.7 patients per year (range, 1-42.8). More than half of the facilities (58%) fit into the lowest quartile (Q1) of patient volume, with a mean volume below 3.2 patients per year. The highest quartile (Q4) by volume included 77 facilities that had a mean volume of at least 9.2 patients per year.
After a median follow-up of 58 months, patients treated at Q4 facilities showed overall survival (OS) rates significantly higher compared with OS rates for patients treated at facilities in the other quartiles. The 5-year OS rate for patients at Q4 facilities was 85%, and at 12 years OS was 76%. In comparison, the 5-year OS rate for patients seen at Q1 facilities was 78%, and at 12 years OS was 63%. For all quartiles, median OS was not reached.
Risk for overall mortality was lower with Q4 facilities compared with facilities in the other quartiles, with Q1 facilities showing an adjusted hazard ratio of 1.29 (95% CI, 1.2-1.39) in comparison with Q4 facilities (P <.0001). Facilities that treated 40 patients per year reported a 27% lower rate of mortality compared with the mortality rate seen by facilities that treated 10 patients per year.
The study investigators concluded that mortality risk was lower for patients with cHL in this study who were treated at facilities that saw higher annual patient volumes.
- Goyal G, Tella SH, Funni S, et al. Association between facility volume and mortality of patients with classic Hodgkin lymphoma [published online November 12, 2019]. Cancer. doi:10.1002/cncr.32584