For patients with metastatic colorectal cancer (CRC), there is wide variation in hospital treatment patterns, according to a study published in Cancer.

Robert W. Krell, M.D., from the University of Michigan in Ann Arbor, and colleagues examined data from the 2006 through 2011 National Cancer Data Base for 84,161 adult patients with newly diagnosed metastatic CRC from 1,051 hospitals.

The authors characterized hospital volume by the use of different treatment modalities, and assessed variation in the receipt of treatment based on the hospitals’ relative volume of services used.

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The researchers observed wide variation in the overall volume of services used (5.0 to 22.3 percent). There were increases in the adjusted rates of metastatic site surgery (6.6 to 30.8 percent; P < 0.001) and multiagent chemotherapy (37.8 versus 57.4 percent; P < 0.001) use as hospitals’ volume of services increased, while there was little variation in primary site resection (56.8 versus 59.5 percent; P = 0.024). Use of palliative care services also increased (8.1 to 11.3 percent; P = 0.002).

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Over time, there was no change in hospital treatment patterns; hospitals with high versus low volumes of service consistently used more metastatic site resection and multiagent chemotherapy.

“There is wide variation in hospital treatment patterns for patients with metastatic CRC, and these patterns have been stable over time,” the authors write.

One author disclosed financial ties to Blue Cross/Blue Shield of Michigan.


  1. Krell, Robert W., MD, et al. “Variation in hospital treatment patterns for metastatic colorectal cancer.” Cancer. DOI: 10.1002/cncr.29253. January 29, 2015.