Cailin Conner

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Cancer treatment outcomes are influenced by numerous factors, including the type of health care facility where patients receive care. Academic cancer centers (ACs) are renowned for the expertise of their health care providers, multidisciplinary approach, and access to cutting-edge treatments and clinical trials. Previous studies have demonstrated improved survival rates for patients with hematologic malignancies treated at ACs. However, the impact of AC treatment on multiple myeloma (MM), a challenging and complex disease, has not been thoroughly examined. Therefore, researchers of a study published in the American Journal of Hematology aimed to evaluate the survival outcomes of patients with MM at Commission on Cancer-accredited ACs compared with the outcomes of patients at nonacademic centers (NACs) that treat MM.
The researchers utilized the National Cancer Database to identify demographics and overall survival (OS) data from patients with MM diagnosed between 2004 and 2017. The study compared outcomes based on the type of health care facility. To ensure a robust analysis, a propensity score-matched cohort was created, pairing NAC patients with AC patients in a 1:1 ratio. The matching factors included age, race, comorbidity score, insurance status, year of diagnosis, distance traveled, and income.
Of the 163,375 patients with MM included in the analysis, 44.5% were treated at ACs. Notably, patients treated at ACs were more likely to receive MM-directed therapy compared with those treated at NACs (81% vs 73%). The median OS for patients receiving treatment was 71.3 months at ACs, significantly longer than the 41.2 months at NACs (P&lt;.001).
When adjusting for baseline demographics, the study found that patients treated at ACs had a reduced risk of mortality (hazard ratio [HR], 0.79; 95% CI, 0.78-0.81). The survival benefit persisted even in the propensity score-matched cohort, where the median OS at ACs was 59.9 months compared with 37.0 months at NACs (HR, 0.66; 95% CI, 0.64-0.67).
Furthermore, the study identified certain socioeconomic factors that influenced facility selection. “ACs treated younger patients with fewer comorbidities and were more likely to treat racial minorities and patients with Medicaid or private insurance and the uninsured,” the authors wrote.
The findings support the idea that the specialized expertise, advanced treatment options, and multidisciplinary care available at ACs play a crucial role in improving patient outcomes. However, the study also highlights the influence of socioeconomic factors on facility selection, indicating the need for efforts to reduce health care disparities and ensure equitable access to high-quality cancer care for all patients, regardless of their socioeconomic status.
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Source: <a href="https://onlinelibrary.wiley.com/doi/10.1002/ajh.26759" target="_blank" rel="noopener">American Journal of Hematology</a>

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