A systematic review and meta-analysis of patient-relevant outcomes in comprehensive cancer centers versus noncomprehensive cancer centers.

Autor: Thamm C; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Cancer and Palliative Care Outcomes Center, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia., Button E; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Cancer and Palliative Care Outcomes Center, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia., Johal J; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia., Knowles R; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia., Gulyani A; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia., Paterson C; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Central Adelaide Local Health Network, Adelaide, South Australia, Australia., Halpern MT; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Healthcare Delivery Research Program, National Cancer Institute, Bethesda, Maryland, USA., Charalambous A; Cyprus University of Technology, Limassol, Cyprus.; University of Turku, Turku, Finland., Chan A; School of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, University of California, Irvine, California, USA., Aranda S; Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia., Taylor C; Global Focus on Cancer, South Salem, New York, USA., Chan RJ; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.; Cancer and Palliative Care Outcomes Center, School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.
Jazyk: angličtina
Zdroj: Cancer [Cancer] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1002/cncr.35646
Abstrakt: This systematic review describes difference in patient-relevant outcomes between comprehensive cancers (CCCs) versus non-CCCs. Studies were identified in PubMed, Cochrane CENTRAL, Epistemonikos, and gray literature from January 2002 to May 2024. Data were extracted and appraised by two authors. Results were narratively synthesized, and meta-analyzed where appropriate. Of 2272 records screened, 36 observational studies were included, predominantly from the United States, and focused on adults with solid cancers. Compared to non-CCCs, studies consistently or predominantly reported superior outcomes at CCCs relating to mortality and survival, quality of peri- and postoperative care, rates of cancer recurrence or progression, and impact on symptoms and health-related quality of life. Meta-analysis showed a significantly lower overall mortality risk of 23% in CCCs compared to non-CCCs (hazard ratio, 0.77; 95% confidence interval, 0.74-0.81, p < .001), with medium heterogeneity (I 2  = 64.61%; Q-test = 36.29, p < .01) observed between the studies. Studies reporting on health equity and costs outcomes consistently or predominantly favored non-CCCs over CCCs. Mixed results were reported for outcomes relating to time to care, palliative and end-of-life care, and health care utilization. The literature reports CCCs are associated with superior outcomes in many areas, especially around mortality and survival. Greater focus is needed to explore outcomes that are important to people with cancer including health-related quality of life, symptoms, and treatment experience, and economic evaluation. Rather than aiming for superior outcomes, CCCs should be striving to enable equitable, high value, patient-centered outcomes for all people affected by cancer.
(© 2024 American Cancer Society.)
Databáze: MEDLINE
Externí odkaz: