Treatment Facility Volume and Survival in Patients with Metastatic Renal Cell Carcinoma: A Registry-based Analysis

Our paper recently published in European Urology demonstrates that treatment facility (TF) volume is directly correlated with improvements in survival outcomes for patients treated for de novo metastatic renal cell carcinoma (mRCC). Following the statistical conclusions of the study, one can extrapolate this benefit indefinitely as TF volume increases.

Another way of looking at the data, however, is to split TFs into high- and low-volume facilities, which we did in the supplementary materials. This may be more intuitive for clinicians as they determine the best treatment environment for their patients.

In our separate analysis, high volume TFs were defined a priori as those in the top 20^th percentile of mean number of mRCC patients treated per year, which was determined to be ≥4.8 patients per year. The unadjusted median OS of all mRCC patients (cohort A) treated at high vs. low volume TFs was 9.5 vs. 6.5 months (p < 0.0001). The figure below demonstrates the Kaplan-Meier survival estimates for high and low volume TFs (cohort A and cohort E) [see cohort Figure below].
UroToday Treatment Facility Volume and Survival in Patients mRCC

UroToday Treatment Facility Volume and Survival in Patients mRCC

Either way you look at it, our data suggest that there is a survival benefit to being treated at higher volume facilities. Efforts to improve outcomes at lower volume facilities, especially those that treat less than 5 patients/year, are crucial to narrow this survival gap.

TF Cohorts BTA

Read the Abstract

Written by: Shreyas S. Joshi, MD, & Daniel M. Geynisman, MD, Fox Chase Cancer Center, Temple Health, Philadelphia, PA

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