Study suggests that supportive care may vary between National Cancer Institute-designated cancer centers and non-designated centers.
National Cancer Institute (NCI)-designated cancer centers are leading the nation’s efforts in oncology research, ranging from basic analysis to clinical trials for novel drugs. There are currently 69 designated centers located across the United States, according to the NCI.
To receive NCI designation, cancer centers must undergo rigorous review and most are associated with university medical centers.
A recent study published by Cancer found that the risk of early mortality was slashed by 53% among patients with acute myeloid leukemia (AML) administered care at an NCI-designated cancer center in California.
“We found the early mortality, deaths less than 60 days after diagnosis, was significantly lower at the NCI-designated cancer centers compared to non-NCI-designated cancer centers in California,” said co-author Brian Jonas, MD, PhD. “We were surprised by the magnitude of the differential.”
The researchers explored data from the California Cancer Registry and the California Office of Statewide Health Planning and Development Patient Discharge Database. The information gathered included sociodemographic, clinical, diagnosis, and treatment data.
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Included in the study were more than 7000 adult patients with AML who were treated with chemotherapy between 1999 and 2014. Approximately 25% of the study population were treated at NCI-designated cancer centers.
Overall, the researchers found that mortality rates improved during the entirety of the study period; however, the most notable improvements occurred at NCI-designated cancer centers.
At these centers, the average early mortality rate was 12% compared with 24% at non-designated centers, according to the study.
The rate of complications such as bleeding, cardiac arrest, and liver, kidney, or respiratory failure did not vary by cancer center.
The authors hypothesize that variations in early mortality indicate inconsistencies in supportive care. They caution that additional studies are necessary to determine the differences that drive the discrepancies.
“This is clearly provocative data that makes you want to understand exactly why,” Dr Jonas said. “We’re going to have to dive into that question in a more significant way.”
The authors also noted that prior research suggests higher patient volumes may lead to better care. In the current study, designated centers saw a median of 13 patients with AML annually, while non-designated centers had an average of 2 per year.
Other factors may include clinical trials, nursing staff, and intensive care units, according to the study.
Future studies should focus on determining the causes of the variations in early mortality, the authors concluded.
“This is a provocative and hopeful paper in terms of improving outcomes,” Dr Jonas said. “It sends a positive message that there are things we could probably do that could help everyone.”