Patients with multiple myeloma who were treated at facilities that care for a higher number of patients with multiple myeloma had a lower risk of mortality compared with those treated at facilities that care for a lower number, a study published in the Journal of Clinical Oncology has shown.1
To determine the relationship between treatment facility volume and all-cause mortality, researchers analyzed data from 94,722 patients treated for multiple myeloma at 1333 facilities. Diagnoses were made between 2003 and 2011 and included in the National Cancer Database.
Investigators classified facilities by quartiles. Facilities in quartile 1 treated an average of less than 3.6 patients with multiple myeloma annually, facilities in quartile 2 treated 3.6 to 6.1 patients per year, facilities in quartile 3 treated 6.1 to 10.3 per year, and those in quartile 4 treated more than 10.3 patients with multiple myeloma per year.
Results showed that facilities treated a median of 6.1 patients per year, with 5.2%, 12.6%, 21.9%, and 60.3% of patients being treated at facilities in quartiles 1, 2, 3, and 4, respectively.
Investigators found that median overall survival with respect to facility volume was 26.9 months in quartile 1, 29.1 months in quartile 2, 31.9 months in quartile 3, and 49.1 months in quartile 4 (P <.001).
The study further demonstrated that patients treated at facilities in quartiles 3, 2, and 1 had a significantly increased the risk of death by 12% (hazard ratio [HR], 1.12; 95% CI, 1.08-1.16), 17% (HR, 1.17; 95% CI, 1.12-1.21), and 22% (HR, 1.22; 95% CI, 1.17-1.28), respectively, compared with those treated at facilities in quartile 4.
The findings ultimately support the growing evidence that a relationship exists between treatment facility volume and outcome in hematologic cancers.
1. Go RS, Bartley AC, Crowson CS, et al. Association between treatment facility volume and mortality of patients with multiple myeloma. J Clin Oncol. 2016 Oct 23. doi: 10.1200/JCO.2016.68.3805. [Epub ahead of print]