ArticleThe Annals of thoracic surgery2023
Multi-institutional Care in Clinical Stage II and III Esophageal Cancer.
Article in The Annals of thoracic surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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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.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Multi-institutional care is associated with improved survival in biliary tract cancer.Journal of gastrointestinal oncology · 2026Article
- Association Between Fragmentation of Care and Delivery of Adjuvant Chemotherapy in Patients Traveling to High-Volume Hospitals for Pancreatic Adenocarcinoma.Annals of surgical oncology · 2026Article
- Fragmentation of care in breast cancer: greater than the sum of its parts.Breast cancer research and treatment · 2024Article
- Assessment of a collaborative treatment model for trimodal management of esophageal cancer.Journal of thoracic disease · 2023Article
- Association of travel distance, surgical volume, and receipt of adjuvant chemotherapy with survival among patients with resectable lung cancer.JTCVS open · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundManagement of clinical stage II or III esophageal cancer requires multidisciplinary care. Multi-institutional care has been associated with worse survival in other malignant diseases. This study aimed to determine the impact of multi-institutional care on survival in patients with stage II or III esophageal cancer.
methodsThe 2004 to 2016 National Cancer Database was queried for patients with clinical stage II or III esophageal cancer who received neoadjuvant chemotherapy with or without radiation therapy followed by surgical resection. Patients were stratified into 2 groups: multi-institutional or single-institution care. Survival between groups was compared using Kaplan-Meier and multivariable Cox proportional hazards methods. Multivariable logistic regression was performed to identify factors associated with multi-institutional care.
resultsOverall, 11 399 patients met study criteria: 6569 (57.6%) received multi-institutional care and 4,830 (42.4%) received care at a single institution. In a multivariable analysis, factors associated with multi-institutional care were later year of diagnosis, greater distance from treating facility, residence in an urban or rural setting (vs metro), and residence in states without Medicaid expansion. Care at a single institution was associated with Black race, lack of insurance, and treatment at higher-volume or academic centers. Despite these differences, patients who received multi-institutional care had survival comparable to that in patients who received care at a single institution (HR, 0.97; 95% CI, 0.92-1.03; P = .30).
conclusionsIn this National Cancer Database analysis, multi-institutional care was not associated with inferior overall survival. As complex cancer care becomes more regionalized, patients may consider receiving part of their cancer care closer to home, whereas traveling to surgical centers of excellence should be encouraged.
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