Hospital volume and beyond first-line palliative systemic treatment in metastatic oesophagogastric adenocarcinoma: A population-based study. (November 2020)

• Record Type: Journal Article
• Authors: Dijksterhuis, Willemieke P.M.; Verhoeven, Rob H.A.; Pape, Marieke; Slingerland, Marije; Haj Mohammad, Nadia; de Vos-Geelen, Judith; Beerepoot, Laurens V.; van Voorthuizen, Theo; Creemers, Geert-Jan; Lemmens, Valery E.P.P.; van Oijen, Martijn G.H.; van Laarhoven, Hanneke W.M.
• Is Part Of: European journal of cancer. Volume 139(2020)
• Page Start: 107
• Page End: 118
• Publication Date: 2020-11
• Subjects: oesophageal neoplasms -- Gastric neoplasms -- Drug therapy -- Palliative treatment; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2020.08.010
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: Beyond first-line palliative systemic treatment can be beneficial to selected oesophagogastric cancer patients, but experience with its administration may be limited and vary among hospitals. In a population-based study, we analysed the association between hospital systemic treatment volume and administration of beyond first-line treatment in oesophagogastric adenocarcinoma, as well as the effect on overall survival (OS). Methods: Synchronous metastatic oesophagogastric adenocarcinoma patients (2010–2017) were selected from the Netherlands Cancer Registry. Hospitals were categorised in volumes quartiles. The association between hospital systemic treatment volume and the use of beyond first-line treatment was assessed using trend and multivariable logistic regression analyses. OS was compared between hospitals with high and low beyond first-line treatment administration and treatment strategies using Kaplan–Meier curves with log-rank test and multivariable Cox proportional hazard regression. Results: Beyond first-line treatment was administered in 606 of 2, 466 patients who received first-line treatment, and increased from 20% to 31% between 2010 and 2017 (P < 0.001). The lowest hospital volumes were independently associated with lower beyond first-line treatment administration compared to the highest volume (OR 0.62, 95% CI 0.39–0.99; OR 0.67, 95% CI 0.48–0.95). Median OS was higher in all patients treated in hospitals with a high versus low beyond first-line treatment administration (7.9 versus 6.2 months, P < 0.001). Second-line paclitaxel/ramucirumab was administered most frequently and independently associated with longer OS compared to taxane monotherapy (HR 0.74, 95% CI 0.59–0.92). Conclusion: Higher hospital volume was associated with increased beyond first-line treatment administration in oesophagogastric adenocarcinoma. Second-line paclitaxel/ramucirumab resulted in longer survival compared to taxane monotherapy. Highlights: Beyond first-line treatment use in oesophagogastric cancer increased between 2010 and 2017. Higher hospital volume is associated with increased beyond first-line treatment use. Patients treated in high-volume beyond first-line treatment hospitals have better OS. Second-line paclitaxel/ramucirumab resulted in longer OS than a taxane alone.