Evidence map›Paper›PMID 35726400›Full record

ArticleBJU international2023

Impact of centralization of prostate cancer services on the choice of radical treatment.

Ajay Aggarwal, Lu Han, Alison Tree, Daniel Lewis, Tom Roques, Vijay Sangar, Jan van der Meulen

Open access · hybridAbstract read
In one paragraph

Article in BJU international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 14% of its field
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

6 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Ajay AggarwalDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0001-9645-6659
Lu HanDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Alison TreeRoyal Marsden Hospital and The Institute for Cancer Research, London, UK.
Daniel LewisDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Tom RoquesNorfolk and Norwich NHS Foundation Trust, Norwich, UK.
Vijay SangarThe Christie NHS Trust and Manchester University NHS Foundation Trust, Manchester, UK.
Jan van der MeulenDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.ORCID 0000-0002-9451-2335
London School of Hygiene & Tropical Medicine · GBGuy's and St Thomas' NHS Foundation Trust · GBNorfolk and Suffolk NHS Foundation Trust · GBRoyal Marsden Hospital · GBUniversity of Manchester · GB

Funding

Cancer Research UK C33589/A28284Cancer Research UK C7224/A28724Department of HealthNational Institute for Health Research NIHR300599
6 · The paper itself

Abstract

objectiveTo assess the impact of centralization of prostate cancer surgery and radiotherapy services on the choice of prostate cancer treatment. PATIENTS AND

methodsThis national population-based study used linked cancer registry data and administrative hospital-level data for all 16 621 patients who were diagnosed between 1 January 2017 and 31 December 2018 with intermediate-risk prostate cancer and who underwent radical prostatectomy (RP) or radical radiation therapy (RT) in the English National Health Service (NHS). Travel times by car to treating centres were estimated using a geographic information system. We used logistic regression to assess the impact of the relative proximity of alternative treatment options on the type of treatment received, with adjustment for patient characteristics.

resultsOf the 78 NHS hospitals that provide RT or RP for prostate cancer, 41% provide both, 36% provide RT and 23% provide RP. Compared to patients who had both treatment options available at their nearest centre where overall 57% of patients received RT and 43% RP, patients were less likely to receive RT if their nearest centre offered RP only and the extra travel time to a hospital providing RT was >15 min (52% of patients received RT and 48% RP%, odds ratio [OR] 0.70 (0.58-0.85); P < 0.001). Conversely, patients were more likely to receive RT if their nearest centre offered RT and the extra travel time to a hospital providing RP was >15 min (63% of patients received RT and 37% RP, OR 1.23 (1.08-1.40); P < 0.001). There was a negligible impact on the type of treatment received if centres providing alternative treatment options were ≤15-min travel time from each other.

conclusionThe relative proximity of prostate cancer treatment options to a patient's residence is an independent predictor for the type of radical treatment received. Centralization policies for prostate cancer should not focus on one treatment modality but should consider all treatments to avoid a negative impact on treatment choice.

Indexed as

Prostatic NeoplasmsState MedicineHospitalsHumansMaleProstatectomyProstate-Specific AntigenProstate-Specific Antigencentralizationpatient choice#PCSMprostate cancer#ProstateCancerradical prostatectomyradical radiotherapytravel time#uroonc

Identifiers

PMID35726400
PMCPMC10084068
OpenAlexW4283208965

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.