Show simple item record

Hospital lymph node counts and survival after radical cystectomy The views expressed herein do not necessarily represent the views of Center for Medicare and Medicaid Services or the United States Government.

dc.contributor.authorHollenbeck, Brent K.en_US
dc.contributor.authorYe, Zajounen_US
dc.contributor.authorWong, Sandra L.en_US
dc.contributor.authorMontie, James E.en_US
dc.contributor.authorBirkmeyer, John D.en_US
dc.date.accessioned2008-03-06T19:08:12Z
dc.date.available2009-03-04T14:20:46Zen_US
dc.date.issued2008-02-15en_US
dc.identifier.citationHollenbeck, Brent K.; Ye, Zajoun; Wong, Sandra L.; Montie, James E.; Birkmeyer, John D. (2008). "Hospital lymph node counts and survival after radical cystectomy The views expressed herein do not necessarily represent the views of Center for Medicare and Medicaid Services or the United States Government. ." Cancer 112(4): 806-812. <http://hdl.handle.net/2027.42/58019>en_US
dc.identifier.issn0008-543Xen_US
dc.identifier.issn1097-0142en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/58019
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=18085612&dopt=citation
dc.description.abstractBACKGROUND. Several studies suggest that patients in whom more lymph nodes are examined have improved survival after radical cystectomy for bladder cancer. Despite growing calls for using lymph node counts as a hospital quality indicator, it has not been established that hospitals that obtain more lymph node have better outcomes. METHODS. Using the national Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database (1992–2003), all patients undergoing radical cystectomy for cancer were identified (n = 3603). Hospitals were ranked and sorted into 3 evenly sized groups: low (no patients with ≥10 lymph nodes removed), medium (up to 20% of patients), and high (greater than 20% of patients). Survival rates were assessed for each hospital group, adjusting for potentially confounding patient and hospital characteristics. RESULTS. On average, low lymph node count hospitals had higher observed mortality rates compared with high lymph node count hospitals (unadjusted hazards ratio [HR], 1.25; 95% confidence interval [95% CI], 1.13–1.39). Low lymph node count hospitals tended to treat patients who were older, had more comorbidity, were of lower socioeconomic status, had higher admission acuity, and had lower procedure volumes. After adjusting for these differences, low lymph node count hospitals tended to have slightly higher mortality (adjusted HR, 1.12; 95% CI, 0.99–1.27), although this finding did not reach statistical significance. Similar findings were evident when other thresholds (lymph node counts ≥5, ≥14, and ≥20) were used. CONCLUSIONS. Hospitals with high lymph node counts tend to have higher survival rates after radical cystectomy for bladder cancer. However, this effect is modest and is explained, in large part, by confounding patient and hospital factors. Cancer 2008. © 2007 American Cancer Society.en_US
dc.format.extent110493 bytes
dc.format.extent3118 bytes
dc.format.mimetypeapplication/pdf
dc.format.mimetypetext/plain
dc.publisherWiley Subscription Services, Inc., A Wiley Companyen_US
dc.subject.otherLife and Medical Sciencesen_US
dc.subject.otherCancer Research, Oncology and Pathologyen_US
dc.titleHospital lymph node counts and survival after radical cystectomy The views expressed herein do not necessarily represent the views of Center for Medicare and Medicaid Services or the United States Government.en_US
dc.typeArticleen_US
dc.rights.robotsIndexNoFollowen_US
dc.subject.hlbsecondlevelOncology and Hematologyen_US
dc.subject.hlbsecondlevelPublic Healthen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumMichigan Surgical Collaborative for Outcomes Research and Evaluation, University of Michigan, Ann Arbor, Michigan ; Department of Urology, University of Michigan, Ann Arbor, Michigan ; Fax: (734) 936-9127 ; Department of Urology, University of Michigan, TC3875 Box 0330, 1500 E. Medical Center Drive, Ann Arbor, MI 48109en_US
dc.contributor.affiliationumDepartment of Urology, University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumMichigan Surgical Collaborative for Outcomes Research and Evaluation, University of Michigan, Ann Arbor, Michigan ; Department of Surgery, University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumDepartment of Urology, University of Michigan, Ann Arbor, Michiganen_US
dc.contributor.affiliationumMichigan Surgical Collaborative for Outcomes Research and Evaluation, University of Michigan, Ann Arbor, Michigan ; Department of Surgery, University of Michigan, Ann Arbor, Michiganen_US
dc.identifier.pmid18085612
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/58019/1/23234_ftp.pdf
dc.identifier.doihttp://dx.doi.org/10.1002/cncr.23234en_US
dc.identifier.sourceCanceren_US
dc.owningcollnameInterdisciplinary and Peer-Reviewed


Files in this item

Show simple item record

Remediation of Harmful Language

The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.

Accessibility

If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.