Evidence map›Paper›PMID 31200840›Full record

SynthesisEuropean urology oncology2019

Impact of Centralizing Care for Genitourinary Malignancies to High-volume Providers: A Systematic Review.

Stephen B Williams, Mohamed D Ray-Zack, Hogan K Hudgins, Jan Oldenburg, Quoc-Dien Trinh, Paul L Nguyen, Neal D Shore, Manfred P Wirth, Timothy O'Brien, James W F Catto

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European urology oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. The Financial Argument for Centralization of Care for Esophagectomy.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026
    Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Stephen B WilliamsDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA. Electronic address: stbwilli@utmb.edu.
Mohamed D Ray-ZackDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
Hogan K HudginsDivision of Urology, The University of Texas Medical Branch, Galveston, TX, USA.
Jan OldenburgDepartment of Oncology, Akershus University Hospital, Lørenskog, Norway.
Quoc-Dien TrinhDivision of Urological Surgery, Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Paul L NguyenDepartment of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Neal D ShoreDepartment of Urology, Carolina Urologic Research Center, Myrtle Beach, SC, USA.
Manfred P WirthDepartment of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Timothy O'BrienGuy's and St. Thomas' NHS Foundation Trust, London, UK.
James W F CattoAcademic Urology Unit, University of Sheffield, Sheffield, UK.

Funding

UTMB Clinical and Translational Science AwardUL1TR001439 · NCATS · UNIVERSITY OF TEXAS MED BR GALVESTON · PI URBAN, RANDALL J · 2015 to 2024
$40.0M
NCATS NIH HHS UL1 TR001439
6 · The paper itself

Abstract

contextThe centralization of cancer care is associated with better clinical outcomes and may be a method for optimizing value-based health care systems.

objectiveTo systematically review the literature regarding the impact of centralization of care on clinical outcomes for genitourinary malignancies. EVIDENCE ACQUISITION: A systematic review was conducted using Ovid and MEDLINE to identify studies between 1970 and 2018 reporting on the centralization of care for genitourinary malignancies. Prospective and retrospective studies were screened. EVIDENCE SYNTHESIS: There were no published randomized control trials (RCTs) on the centralization of care for genitourinary malignancies. Twenty-two retrospective studies met inclusion criteria. Centralization of radical cystectomy was the most studied. Care for bladder cancer, prostate cancer, penile cancer, testicular cancer, and renal cancer was reportedly associated with better morbidity and survival outcomes for patients treated at high-volume centers. However, evidence of better outcomes for centralization of care remains limited for penile, renal, and testicular cancers owing to the paucity of data and/or the lower incidence of these genitourinary malignancies.

conclusionsCare for genitourinary malignancies by high-volume providers was associated with greater utilization of cancer surgery, lower morbidity, and better survival outcomes. Centralization of care was most appropriate for complex procedures such as radical cystectomy when interpreted in the context of survival outcomes. Further research is needed to address the impact of centralizing care for all urologic malignancies with consideration of the associated costs and patient-reported measures, including quality of life and patient experience. PATIENT SUMMARY: We explored the evidence for moving major operations into larger centers. We focused on surgery for cancers of the bladder, prostate, testicle, penis, and kidney, and found that larger-volume hospitals had better survival outcomes and fewer complications when compared to smaller hospitals. The difference may be greatest for complex major surgeries such as radical cystectomy.

Indexed as

Cancer Care FacilitiesCystectomyDelivery of Health CareHospital MortalityHospitals, High-VolumeHumansLength of StayTreatment OutcomeUrogenital NeoplasmsCancerCentralizationGenitourinaryOutcomesSurvivalUrologyUseUtilization

Identifiers

PMID31200840
PMCPMC10007401

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.