Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands

Jesper van Breeschoten; Alfonsus J.M. van den Eertwegh; Liesbeth C. de Wreede; Doranne L. Hilarius; Erik W. van Zwet; John B. Haanen; Christian U. Blank; Maureen J.B. Aarts; Franchette W.P.J. van den Berkmortel; Jan Willem B. de Groot; Geke A.P. Hospers; Ellen Kapiteijn; Djura Piersma; Rozemarijn S. van Rijn; Marion A.M. Stevense‐Den Boer; Astrid A.M. van der Veldt; Gerard Vreugdenhil; Marye J. Boers‐sonderen; Karijn P.M. Suijkerbuijk; Michel W.J.M. Wouters

doi:10.3390/cancers13205077

Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands

Jesper van Breeschoten, Alfonsus J.M. van den Eertwegh, Liesbeth C. de Wreede, Doranne L. Hilarius, Erik W. van Zwet, John B. Haanen, Christian U. Blank, Maureen J.B. Aarts, Franchette W.P.J. van den Berkmortel, Jan Willem B. de Groot, Geke A.P. Hospers, Ellen Kapiteijn, Djura Piersma, Rozemarijn S. van Rijn, Marion A.M. Stevense‐Den Boer, Astrid A.M. van der Veldt, Gerard Vreugdenhil, Marye J. Boers‐sonderen, Karijn P.M. Suijkerbuijk, Michel W.J.M. Wouters^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

BACKGROUND: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands.

METHODS: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared.

RESULTS: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers.

CONCLUSION: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.

Original language	English
Article number	5077
Journal	Cancers
Volume	13
Issue number	20
DOIs	https://doi.org/10.3390/cancers13205077
Publication status	Published - 11 Oct 2021

Bibliographical note

Funding Information:
For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start?up grant from governmental organization The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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Hospital Variation in Cancer Treatments and Survival OutComes of Advanced Melanoma PatientsFinal published version, 3.02 MBLicence: CC BY

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van Breeschoten, J., van den Eertwegh, A. J. M., de Wreede, L. C., Hilarius, D. L., van Zwet, E. W., Haanen, J. B., Blank, C. U., Aarts, M. J. B., van den Berkmortel, F. W. P. J., de Groot, J. W. B., Hospers, G. A. P., Kapiteijn, E., Piersma, D., van Rijn, R. S., Stevense‐Den Boer, M. A. M., van der Veldt, A. A. M., Vreugdenhil, G., Boers‐sonderen, M. J., Suijkerbuijk, K. P. M., & Wouters, M. W. J. M. (2021). Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands. Cancers, 13(20), Article 5077. https://doi.org/10.3390/cancers13205077

@article{0f95ca6424d04dc8a018795a34a48b30,

title = "Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands",

abstract = "BACKGROUND: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands.METHODS: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared.RESULTS: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers.CONCLUSION: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.",

author = "{van Breeschoten}, Jesper and {van den Eertwegh}, {Alfonsus J.M.} and {de Wreede}, {Liesbeth C.} and Hilarius, {Doranne L.} and {van Zwet}, {Erik W.} and Haanen, {John B.} and Blank, {Christian U.} and Aarts, {Maureen J.B.} and {van den Berkmortel}, {Franchette W.P.J.} and {de Groot}, {Jan Willem B.} and Hospers, {Geke A.P.} and Ellen Kapiteijn and Djura Piersma and {van Rijn}, {Rozemarijn S.} and {Stevense‐Den Boer}, {Marion A.M.} and {van der Veldt}, {Astrid A.M.} and Gerard Vreugdenhil and Boers‐sonderen, {Marye J.} and Suijkerbuijk, {Karijn P.M.} and Wouters, {Michel W.J.M.}",

note = "Funding Information: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start?up grant from governmental organization The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = oct,

day = "11",

doi = "10.3390/cancers13205077",

language = "English",

volume = "13",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "20",

}

van Breeschoten, J, van den Eertwegh, AJM, de Wreede, LC, Hilarius, DL, van Zwet, EW, Haanen, JB, Blank, CU, Aarts, MJB, van den Berkmortel, FWPJ, de Groot, JWB, Hospers, GAP, Kapiteijn, E, Piersma, D, van Rijn, RS, Stevense‐Den Boer, MAM, van der Veldt, AAM, Vreugdenhil, G, Boers‐sonderen, MJ, Suijkerbuijk, KPM & Wouters, MWJM 2021, 'Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands', Cancers, vol. 13, no. 20, 5077. https://doi.org/10.3390/cancers13205077

TY - JOUR

T1 - Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients

T2 - Nationwide quality assurance in the netherlands

AU - van Breeschoten, Jesper

AU - van den Eertwegh, Alfonsus J.M.

AU - de Wreede, Liesbeth C.

AU - Hilarius, Doranne L.

AU - van Zwet, Erik W.

AU - Haanen, John B.

AU - Blank, Christian U.

AU - Aarts, Maureen J.B.

AU - van den Berkmortel, Franchette W.P.J.

AU - de Groot, Jan Willem B.

AU - Hospers, Geke A.P.

AU - Kapiteijn, Ellen

AU - Piersma, Djura

AU - van Rijn, Rozemarijn S.

AU - Stevense‐Den Boer, Marion A.M.

AU - van der Veldt, Astrid A.M.

AU - Vreugdenhil, Gerard

AU - Boers‐sonderen, Marye J.

AU - Suijkerbuijk, Karijn P.M.

AU - Wouters, Michel W.J.M.

N1 - Funding Information: For the Dutch Melanoma Treatment Registry (DMTR), the Dutch Institute for Clinical Auditing foundation received a start?up grant from governmental organization The Netherlands Organization for Health Research and Development (ZonMW, project number 836002002). The DMTR is structurally funded by Bristol Myers Squibb, Merck Sharpe & Dohme, Novartis and Roche Pharma. Roche Pharma stopped funding in 2019 and Pierre Fabre started funding of the DMTR in 2019. For this work, no funding was granted. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/10/11

Y1 - 2021/10/11

N2 - BACKGROUND: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands.METHODS: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared.RESULTS: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers.CONCLUSION: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.

AB - BACKGROUND: To assure a high quality of care for patients treated in Dutch melanoma centers, hospital variation in treatment patterns and outcomes is evaluated in the Dutch Melanoma Treatment Registry. The aim of this study was to assess center variation in treatments and 2-year survival probabilities of patients diagnosed between 2013 and 2017 in the Netherlands.METHODS: We selected patients diagnosed between 2013 and 2017 with unresectable IIIC or stage IV melanoma, registered in the Dutch Melanoma Treatment Registry. Centers' performance on 2-year survival was evaluated using Empirical Bayes estimates calculated in a random effects model. Treatment patterns of the centers with the lowest and highest estimates for 2-year survival were compared.RESULTS: For patients diagnosed between 2014 and 2015, significant center variation in 2-year survival probabilities was observed even after correcting for case-mix and treatment with new systemic therapies. The different use of new systemic therapies partially explained the observed variation. From 2016 onwards, no significant difference in 2-year survival was observed between centers.CONCLUSION: Our data suggest that between 2014 and 2015, after correcting for patient case-mix, significant variation in 2-year survival probabilities between Dutch melanoma centers existed. The use of new systemic therapies could partially explain this variation. In 2013 and between 2016 and 2017, no significant variation between centers existed.

UR - http://www.scopus.com/inward/record.url?scp=85116757063&partnerID=8YFLogxK

U2 - 10.3390/cancers13205077

DO - 10.3390/cancers13205077

M3 - Article

C2 - 34680228

AN - SCOPUS:85116757063

SN - 2072-6694

VL - 13

JO - Cancers

JF - Cancers

IS - 20

M1 - 5077

ER -

Hospital variation in cancer treatments and survival outcomes of advanced melanoma patients: Nationwide quality assurance in the netherlands

Abstract

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