Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival

David Roder, Margaret Davy, Sid Selva-Nayagam, Sellvakumaram Paramasivam, Jacqui Adams, Dorothy Keefe, Ian Olver, Caroline Miller, Elizabeth Buckley, Kate Powell, Kellie Fusco, Dianne Buranyi-Trevarton, Martin K. Oehler

Research output: Contribution to journalArticle

Abstract

Background: The value of hospital registries for describing treatment and survival outcomes for vulval cancer was investigated. Hospital registry data from four major public hospitals in 1984-2016 were used because population-based data lacked required treatment and outcomes data. Unlike population registries, the hospital registries had recorded FIGO stage, grade and treatment. Methods: Unadjusted and adjusted disease-specific survival and multiple logistic regression were used. Disease-specific survivals were explored using Kaplan-Meier product-limit estimates. Hazards ratios (HRs) were obtained from proportional hazards regression for 1984-1999 and 2000-2016. Repeat analyses were undertaken using competing risk regression. Results: Five-year disease-specific survival was 70%, broadly equivalent to the five-year relative survivals reported for Australia overall (70%), the United Kingdom (70%), USA (72%), Holland (70%), and Germany (Munich) (68%). Unadjusted five-year survival tended to be lower for cancers diagnosed in 2000-2016 than 1984-1999, consistent with survival trends reported for the USA and Canada, but higher for 2000-2016 than 1984-1999 after adjusting for stage and other covariates, although differences were small and did not approach statistical significance (p≥0.40). Surgery was provided as part of the primary course of treatment for 94% of patients and radiotherapy for 26%, whereas chemotherapy was provided for only 6%. Less extensive surgical procedures applied in 2000-2016 than 1984-1999 and the use of chemotherapy increased over these periods. Surgery was more common for early FIGO stages, and radiotherapy for later stages with a peak for stage III. Differences in treatment by surgery and radiotherapy were not found by geographic measures of remoteness and socioeconomic status in adjusted analyses, suggesting equity in service delivery. Conclusions: The data illustrate the complementary value of hospital-registry data to population-registry data for informing local providers and health administrations of trends in management and outcomes, in this instance for a comparatively rare cancer that is under-represented in trials and under-reported in national statistics. Hospital registries can fill an evidence gap when clinical data are lacking in population-based registries.

LanguageEnglish
Article number858
JournalBMC Cancer
Volume18
Issue number1
DOIs
Publication statusPublished - 30 Aug 2018

Keywords

  • Vulval cancer stage treatment survival

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Roder, D., Davy, M., Selva-Nayagam, S., Paramasivam, S., Adams, J., Keefe, D., ... Oehler, M. K. (2018). Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival. BMC Cancer, 18(1), [858]. https://doi.org/10.1186/s12885-018-4759-x
Roder, David ; Davy, Margaret ; Selva-Nayagam, Sid ; Paramasivam, Sellvakumaram ; Adams, Jacqui ; Keefe, Dorothy ; Olver, Ian ; Miller, Caroline ; Buckley, Elizabeth ; Powell, Kate ; Fusco, Kellie ; Buranyi-Trevarton, Dianne ; Oehler, Martin K. / Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival. In: BMC Cancer. 2018 ; Vol. 18, No. 1.
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abstract = "Background: The value of hospital registries for describing treatment and survival outcomes for vulval cancer was investigated. Hospital registry data from four major public hospitals in 1984-2016 were used because population-based data lacked required treatment and outcomes data. Unlike population registries, the hospital registries had recorded FIGO stage, grade and treatment. Methods: Unadjusted and adjusted disease-specific survival and multiple logistic regression were used. Disease-specific survivals were explored using Kaplan-Meier product-limit estimates. Hazards ratios (HRs) were obtained from proportional hazards regression for 1984-1999 and 2000-2016. Repeat analyses were undertaken using competing risk regression. Results: Five-year disease-specific survival was 70{\%}, broadly equivalent to the five-year relative survivals reported for Australia overall (70{\%}), the United Kingdom (70{\%}), USA (72{\%}), Holland (70{\%}), and Germany (Munich) (68{\%}). Unadjusted five-year survival tended to be lower for cancers diagnosed in 2000-2016 than 1984-1999, consistent with survival trends reported for the USA and Canada, but higher for 2000-2016 than 1984-1999 after adjusting for stage and other covariates, although differences were small and did not approach statistical significance (p≥0.40). Surgery was provided as part of the primary course of treatment for 94{\%} of patients and radiotherapy for 26{\%}, whereas chemotherapy was provided for only 6{\%}. Less extensive surgical procedures applied in 2000-2016 than 1984-1999 and the use of chemotherapy increased over these periods. Surgery was more common for early FIGO stages, and radiotherapy for later stages with a peak for stage III. Differences in treatment by surgery and radiotherapy were not found by geographic measures of remoteness and socioeconomic status in adjusted analyses, suggesting equity in service delivery. Conclusions: The data illustrate the complementary value of hospital-registry data to population-registry data for informing local providers and health administrations of trends in management and outcomes, in this instance for a comparatively rare cancer that is under-represented in trials and under-reported in national statistics. Hospital registries can fill an evidence gap when clinical data are lacking in population-based registries.",
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Roder, D, Davy, M, Selva-Nayagam, S, Paramasivam, S, Adams, J, Keefe, D, Olver, I, Miller, C, Buckley, E, Powell, K, Fusco, K, Buranyi-Trevarton, D & Oehler, MK 2018, 'Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival', BMC Cancer, vol. 18, no. 1, 858. https://doi.org/10.1186/s12885-018-4759-x

Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival. / Roder, David; Davy, Margaret; Selva-Nayagam, Sid; Paramasivam, Sellvakumaram; Adams, Jacqui; Keefe, Dorothy; Olver, Ian; Miller, Caroline; Buckley, Elizabeth; Powell, Kate; Fusco, Kellie; Buranyi-Trevarton, Dianne; Oehler, Martin K.

In: BMC Cancer, Vol. 18, No. 1, 858, 30.08.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Using hospital registries in Australia to extend data availability on vulval cancer treatment and survival

AU - Roder, David

AU - Davy, Margaret

AU - Selva-Nayagam, Sid

AU - Paramasivam, Sellvakumaram

AU - Adams, Jacqui

AU - Keefe, Dorothy

AU - Olver, Ian

AU - Miller, Caroline

AU - Buckley, Elizabeth

AU - Powell, Kate

AU - Fusco, Kellie

AU - Buranyi-Trevarton, Dianne

AU - Oehler, Martin K.

PY - 2018/8/30

Y1 - 2018/8/30

N2 - Background: The value of hospital registries for describing treatment and survival outcomes for vulval cancer was investigated. Hospital registry data from four major public hospitals in 1984-2016 were used because population-based data lacked required treatment and outcomes data. Unlike population registries, the hospital registries had recorded FIGO stage, grade and treatment. Methods: Unadjusted and adjusted disease-specific survival and multiple logistic regression were used. Disease-specific survivals were explored using Kaplan-Meier product-limit estimates. Hazards ratios (HRs) were obtained from proportional hazards regression for 1984-1999 and 2000-2016. Repeat analyses were undertaken using competing risk regression. Results: Five-year disease-specific survival was 70%, broadly equivalent to the five-year relative survivals reported for Australia overall (70%), the United Kingdom (70%), USA (72%), Holland (70%), and Germany (Munich) (68%). Unadjusted five-year survival tended to be lower for cancers diagnosed in 2000-2016 than 1984-1999, consistent with survival trends reported for the USA and Canada, but higher for 2000-2016 than 1984-1999 after adjusting for stage and other covariates, although differences were small and did not approach statistical significance (p≥0.40). Surgery was provided as part of the primary course of treatment for 94% of patients and radiotherapy for 26%, whereas chemotherapy was provided for only 6%. Less extensive surgical procedures applied in 2000-2016 than 1984-1999 and the use of chemotherapy increased over these periods. Surgery was more common for early FIGO stages, and radiotherapy for later stages with a peak for stage III. Differences in treatment by surgery and radiotherapy were not found by geographic measures of remoteness and socioeconomic status in adjusted analyses, suggesting equity in service delivery. Conclusions: The data illustrate the complementary value of hospital-registry data to population-registry data for informing local providers and health administrations of trends in management and outcomes, in this instance for a comparatively rare cancer that is under-represented in trials and under-reported in national statistics. Hospital registries can fill an evidence gap when clinical data are lacking in population-based registries.

AB - Background: The value of hospital registries for describing treatment and survival outcomes for vulval cancer was investigated. Hospital registry data from four major public hospitals in 1984-2016 were used because population-based data lacked required treatment and outcomes data. Unlike population registries, the hospital registries had recorded FIGO stage, grade and treatment. Methods: Unadjusted and adjusted disease-specific survival and multiple logistic regression were used. Disease-specific survivals were explored using Kaplan-Meier product-limit estimates. Hazards ratios (HRs) were obtained from proportional hazards regression for 1984-1999 and 2000-2016. Repeat analyses were undertaken using competing risk regression. Results: Five-year disease-specific survival was 70%, broadly equivalent to the five-year relative survivals reported for Australia overall (70%), the United Kingdom (70%), USA (72%), Holland (70%), and Germany (Munich) (68%). Unadjusted five-year survival tended to be lower for cancers diagnosed in 2000-2016 than 1984-1999, consistent with survival trends reported for the USA and Canada, but higher for 2000-2016 than 1984-1999 after adjusting for stage and other covariates, although differences were small and did not approach statistical significance (p≥0.40). Surgery was provided as part of the primary course of treatment for 94% of patients and radiotherapy for 26%, whereas chemotherapy was provided for only 6%. Less extensive surgical procedures applied in 2000-2016 than 1984-1999 and the use of chemotherapy increased over these periods. Surgery was more common for early FIGO stages, and radiotherapy for later stages with a peak for stage III. Differences in treatment by surgery and radiotherapy were not found by geographic measures of remoteness and socioeconomic status in adjusted analyses, suggesting equity in service delivery. Conclusions: The data illustrate the complementary value of hospital-registry data to population-registry data for informing local providers and health administrations of trends in management and outcomes, in this instance for a comparatively rare cancer that is under-represented in trials and under-reported in national statistics. Hospital registries can fill an evidence gap when clinical data are lacking in population-based registries.

KW - Vulval cancer stage treatment survival

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U2 - 10.1186/s12885-018-4759-x

DO - 10.1186/s12885-018-4759-x

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JO - BMC cancer

T2 - BMC cancer

JF - BMC cancer

SN - 1471-2407

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