Does Facility Volume Impact Survival Outcomes in Merkel Cell Carcinoma?
Posted: Wednesday, August 19, 2020
According to research published in the Journal of Surgical Oncology, patients with Merkel cell carcinoma who receive treatment at high-volume facilities may experience improved overall survival versus patients who receive treatment at lower-volume facilities. Zachary S. Zumsteg, MD, of Cedars-Sinai Medical Center, Los Angeles, and colleagues defined facility volume as the number of nonmetastatic surgical cases diagnosed at a given facility.
The study included 5,304 patients with stage I to III Merkel cell carcinoma who had undergone surgical treatment. Treatment data were sourced from the National Cancer Database, and the top 1% of facilities by case volume were designated high-volume facilities.
An independent association was observed between patients undergoing treatment at a high-volume facility (hazard ratio = 0.74; 95% confidence interval = 0.65–0.84, P < .001) and patients experiencing improved overall survival. The 5-year overall survival rate was 62.3% for patients treated at high-volume facilities versus 56.8% for those treated at lower-volume facilities (P < .001) in propensity score–matched cohorts. Patients treated at high-volume facilities also experienced an improved median overall survival of 111 months versus 79 months.
“Given the impracticality in having all patients with Merkel cell carcinoma receive treatment at high-volume facilities, novel strategies to mitigate any potential disparities in care between high-volume facilities and low-volume facilities should be explored,” concluded the authors.
Disclosure: For full disclosures of the study authors, visit onlinelibrary.wiley.com.
