Survival after treatment for carcinoma invading bladder muscle: a Dutch population‐based study on the impact of hospital volume

摘要: Study Type – Prognosis (cohort) Level of Evidence 2a What's known on the subject? and What does study add? The subject mortality survival rates after radical cystectomies in high-volume hospitals comparison to low-volume has been extensively studied. Postoperative is be significantly lower with providers, but for there was only a trend forwards this finding. For reason, we performed Dutch population-based rates, see if had enough power support significant findings. To our knowledge, first good quality showing beneficial effect hospitals. OBJECTIVE •  To examine volume–outcome relationship carcinoma invading bladder muscle (MIBC) respect differences among all Netherlands as guide regionalization initiatives. MATERIALS AND METHODS •  This retrospective included patients (n= 13 033) newly diagnosed MIBC during period 1999–2008 Netherlands, selected from Cancer Registry. •  Data were collected demographics, morphology, stage at diagnosis surgery, primary treatment, vital status date follow-up or death. •  The relative rate (RSR) per treatment analysed age, hospital surgical volume. RESULTS •  Overall 5 10-year RSR treatments 32% 25%, respectively. •  Although 71.7% featured stages II III, cystectomy 42% 44% these patients, respectively. •  Relative remained unchanged two consecutive time periods (1999–2003 2004–2008). •  In all, 34% (<10 cystectomies/year) underwent vs those (P= 0.000). •  In multivariate analysis long-term (>30 days surgery) II/III (hazard ratio [HR] 1.17, P= 0.036). A high lymph node count (>20) associated risk death (HR 0.52, 0.000). CONCLUSIONS •  The modest (25%) last decade. •  The chance undergoing higher hospitals. Long-term hospitals. •  Regionalization cancer could improve overall outcomes.