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The volume effect in paediatric oncology: a systematic review
R R G Knops1, E C van Dalen1, R L Mulder1
1Department of Paediatric Oncology, Emma Children's Hospital/Academic Medical Centre, Amsterdam.
Summary
Treating childhood cancer in high-volume hospitals or with specialized providers improves outcomes. This systematic review confirms that increased provider case volume is linked to better results in pediatric oncology, with no negative effects reported.
Area of Science:
- Pediatric Oncology
- Health Services Research
- Cancer Care Quality
Background:
- Evidence suggests high-volume treatment centers improve outcomes for adult cancers.
- The impact of provider and hospital case volume on pediatric cancer care quality and survival is less understood.
- This study systematically reviews the existing evidence on the volume effect in pediatric oncology.
Purpose of the Study:
- To provide a comprehensive overview of the evidence regarding the volume effect in pediatric oncology.
- To assess the relationship between provider/hospital case volume and quality of care or survival in childhood cancer.
- To synthesize findings from existing studies on treatment volume in pediatric cancer.
Main Methods:
- An extensive literature search was conducted to identify relevant studies.
- Studies focused on the effect of provider case volume on quality of care or survival in childhood cancer.
- Data on study characteristics, comparisons, results, and quality were systematically abstracted.
Main Results:
- Fourteen studies were included in this systematic review.
- Studies with low risk of bias indicate better outcomes for specific pediatric cancers (brain tumors, ALL, osteosarcoma, Ewing sarcoma) and bone marrow transplants in high-volume settings.
- Higher volume hospitals, specialized centers, and high case volume providers are associated with improved outcomes.
Conclusions:
- This systematic review supports the association between higher volume care settings and improved outcomes in pediatric oncology.
- No studies reported a negative impact of higher volume on pediatric cancer treatment outcomes.
- Consolidating care in specialized, high-volume centers may enhance pediatric cancer patient survival and quality of care.
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