2019-2020 Treatment Results - FOR PATIENTS AND CAREGIVERS - Cancer Treatment Centers
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Cancer Treatment Centers of America Global, Inc.
2019-2020
Treatment Results
FOR PATIENTS AND CAREGIVERS
Elaine B., Breast Cancer
CTCA Tulsa
LENGTH OF LIFE | QUALIT Y OF LIFE | PATIENT EXPERIENCE | PATIENT SAFE T Y | QUALIT Y OF CARE
Table of Contents
PATIENT TREATMENT RESULTS 2019 | 2020
SECTION 1 SECTION 4
Dear Patients and Caregivers, About this Report Our Patient Experience Results
3 Why We Publish Our Treatment Results 35 HCAHPS Inpatient Survey
We believe all patients should have access to as much information as possible in order to make Background and Methodology
the most informed decisions about their care. As part of that commitment, we are pleased to share 3 Our Commitment to Transparency
with you this seventh annual edition of our Patient Treatment Results. Cancer Treatment Centers 3 Our Beginnings 36 Inpatient Satisfaction Results
of America® (CTCA) was among the first cancer care providers in the nation to make treatment 42 OAS CAHPS Survey Background
4 Our Beliefs
results available to the general public, and, to our knowledge, this is the most comprehensive and Methodology
presentation of treatment results now published by any cancer care provider. It reflects the quality 4 Accessibility
42 Outpatient and Ambulatory Surgery
of clinical care we have provided to patients from around the world at our comprehensive care and 4 Health Insurance and Verification Patient Satisfaction Results
research centers and outpatient care centers in Atlanta, Chicago, Philadelphia, Phoenix and Tulsa.
5 Sponsors of this Report 46 Outpatient Survey Background
Five-year survival rates for CTCA® patients treated between 2000 and 2015 are provided for 11 6 CTCA Patient Demographics and Methodology
cancer types. For reference, we have also provided companion data for the same cancer types
46 Outpatient Satisfaction Results
and timeframe as reported by the National Cancer Institute in its Surveillance, Epidemiology and SECTION 2
End Results (SEER) Program, which is undertaken in collaboration with the American College of 52 Physician Transparency Star Rating
Surgeons and American Cancer Society. Our Length of Life Results Background, Methodology and Results
9 Independent Researchers’ Letter
The CTCA patient survival data appearing in this publication were independently analyzed and SECTION 5
interpreted by Bert Spilker, MD, PhD, and Chengjie Xiong, PhD. Their biographical sketches are 10 Statistical Methodology
included in this publication. Neither is affiliated with, or employed by, CTCA. 13 Breast Cancer
Safe Care, Quality Care
53 Our Philosophy and Methodology
Additionally, we have included data on various safety and quality of care measurements during 14 Colon Cancer
treatment, critically important results not commonly reported by most cancer providers, as well 54 AHRQ Survey: Patient Safety Culture
15 Esophageal Cancer
as patient self-reports of quality of life and the overall patient experience. 58 Quality Metrics
16 Kidney Cancer
All data sources and survey methodologies are provided in their respective sections throughout 63 Overall QOPI Quality Score and QOPI Metrics
17 Non-Small Cell Lung Cancer
the publication. 66 Project-Specific Areas of Focus
18 Small Cell Lung Cancer
We hope you find this important information valuable, and we would be pleased to respond to 19 Ovarian Cancer SECTION 6
any feedback or questions you may have about the results.
20 Pancreatic Cancer Our Clinical Leadership
Thank you for your interest in Cancer Treatment Centers of America. 21 Prostate Cancer 69 Medicine & Science
Sincerely, 22 Rectal Cancer 69 Department Chairs and Vice Chairs
23 Stomach Cancer 71 Chiefs of Staff
SECTION 3 SECTION 7
Our Quality of Life Results Our Research
Maurie Markman, MD
25 Assessment Background 73 Publications and Presentations
President, Medicine & Science
and Methodology
Cancer Treatment Centers of America 79 Accreditations and Certifications
27 Quality of Life Results by Cancer Type
32 Quality of Life Results in
Aggregate and by Facility
© 2019 IPB
About this Report 1
Our Length of Life Results
Our Vision
To be recognized and trusted by people Our Quality of Life Results
living with cancer as the premier center
for healing and hope.
Our Mission Our Patient Experience Results
CTCA® is the home of integrative
and compassionate cancer care.
We never stop searching for and providing
powerful and innovative therapies
to heal the whole person,
Our Patient Safety and Quality Results
improve quality of life and restore hope.
Our Values
Hopeful Our Clinical Leadership
Compassionate
Empowering
Ethical
Responsive
Innovative Our Research Publications
Team Spirited
About This Report
Why We Publish our Treatment Results
At Cancer Treatment Centers of America® (CTCA), we became one of the first in the country to offer a full
believe in empowering patients. We believe patients range of integrative treatment services, including
deserve access to information—especially health surgery, chemotherapy and radiation therapy as
outcomes, including survival, patient safety and well as nutrition, mind-body and spiritual support.
quality care data as well as patient self-reported data In 1990, CTCA opened a second hospital, located
on care experience and symptom management. in Tulsa, Oklahoma, establishing itself as a premier
When patients have access to information about center of hope and healing for cancer patients.
the centers and professionals to whom they
entrust their lives, they are able to make more As demand grew, the CTCA hospital in Zion was
informed decisions about their care. expanded twice. In 1991, CTCA broke ground on
a five-story, 78,886-square-foot facility. Then in
OUR COMMITMENT TO TRANSPARENCY 2015, a six-story 168,078-square-foot inpatient
tower became the centerpiece of a campus-wide
At CTCA®, we believe that transparency in the modernization.
publication of our treatment results is vital to
upholding our promise to patients and their CTCA also expanded its presence in Tulsa by
families. Regardless of the outcome, it holds us opening a state-of-the-art hospital in 2005. The
accountable to continually improve the care we stunning 195,845-square-foot center became
deliver. We engage leading independent research Oklahoma’s only major hospital completely
organizations, such as Bert Spilker & Associates, LLC, focused on treating cancer. Also in 2005, CTCA
Press Ganey® and Healthcare Performance Philadelphia opened its doors, becoming the first
Improvement (HPI®) to conduct various analyses CTCA hospital on the East Coast.
of our treatment results. We utilize valid and tested CTCA Phoenix, a modern 210,000-square-foot
tools and participate in nationally recognized hospital located in Goodyear, Arizona (suburban
activities to further our commitment to safe, high- Phoenix) joined the CTCA family in 2008. In 2012,
quality care for the patients we serve. CTCA Atlanta began welcoming patients to its
location in suburban Newnan.
OUR BEGINNINGS
Job L. | E S O P H AG E A L C A N C E R | CTCA Tulsa Building on the goal of offering patients increased
In the early 1980s, Richard J Stephenson and his access to advanced cancer therapies and
family suffered the loss of their mother, Mary personalized care in convenient, cost-effective
“Throughout my treatment, I was impressed with the commitment to the Mother Brown Stephenson, to cancer. When she died, her outpatient settings, in 2018 and 2019 CTCA
grieving son and his family asked, “What would it opened five outpatient care centers in Chicago,
Standard® of care, the belief that patients are taken care of the way you would want take to actually change the face of cancer care?” Phoenix and their surrounding communities.
any member of your family treated. CTCA truly cared about my patient experience, In 1988, CTCA was born, founded on what is now
known as the Mother Standard® of care—a patient-
treating my whole person and actively monitoring my quality of life. Any issues were
centered approach that combines compassion
quickly addressed, and I had access to a variety of supportive care therapies that I with advanced technology and treatment options.
took advantage of.” The American International Hospital in Zion, Illinois,
located between Chicago and Milwaukee, served
as the first CTCA location. With Mr. Stephenson
as chairman of the board, the cancer program
ABOUT THIS REPOR T 3
Sponsors of this Report
OUR BELIEFS Accessibility, Services and Insurance:
The CTCA Comprehensive Cancer Care Network Reducing the Stress of Cancer Care
of hospitals and outpatient care centers
offers an integrative approach to care that
combines surgery, radiation, chemotherapy and ACCESSIBILITY
immunotherapy with advancements in precision CTCA understands that speed and accessibility of
cancer treatment and supportive therapies care are important to patients and their caregivers, SPONSORS OF THIS REPORT
designed to manage side effects and enhance which is why we are dedicated to providing
quality of life both during and after treatment. efficient, convenient cancer care for our patients
At CTCA, each patient is served by a while reducing their stress as much as possible. Maurie Markman, MD Julian Schink, MD
multidisciplinary team of physicians, nurses, President, Medicine & Science Chief Medical Officer
CTCA Comprehensive Cancer Care Network
registered dietitians and other care providers. CTCA CTCA
hospitals and outpatient care centers are located
These teams include individuals with extensive in or near five major U.S. cities: Atlanta, Chicago, A nationally renowned board-certified Dr. Schink brings more than 25
experience in treating cancer. Together they Philadelphia, Phoenix and Tulsa. Each city has an medical oncologist, Dr. Markman years of oncology experience to
develop and implement an individualized airport that is serviced by most major airlines. We is President of Medicine and Science and serves his position as Chief Medical Officer at CTCA.
treatment plan tailored to each patient’s assist many patients with travel arrangements, on the National Board of Directors at CTCA. Dr. Board-certified in gynecologic oncology as well
unique diagnosis and life goals. including lodging accommodations for themselves, Markman has more than 20 years of experience in as obstetrics and gynecology, he is dedicated to
For these reasons, patients, physicians, employers their caregivers and families either on-site at our cancer treatment and gynecologic research. caring for patients and advancing the treatment of
and insurers can depend on CTCA to offer hospitals or in nearby hotels. For his remarkable achievements in clinical practice gynecologic malignancies.
comprehensive, compassionate and truly and oncology research, Dr. Markman was recently Prior to joining CTCA, Dr. Schink held numerous
personalized cancer care. HEALTH INSURANCE AND VERIFICATION named by OncLive® as an inductee of the 2018 academic positions, including Vice Chair of
CTCA verifies the insurance and benefits of Giants of Cancer Care® recognition program. In obstetrics and gynecology and professor at
prospective patients, including in-network 2011, he received the esteemed American Society the University of Wisconsin Medical School,
and out-of-network benefits, deductibles, plan of Clinical Oncology (ASCO) Statesman Award. and subsequently an endowed professorship
coverage percentages and co-pays. The verification Presented annually, the Statesman Award recognizes at Northwestern University Feinberg School of
process typically takes less than 24 hours. CTCA individual ASCO members who have shown Medicine as the John and Ruth Brewer Chair in
financial counselors are also available to patients extraordinary volunteer service, dedication and Gynecology and Cancer Research.
and caregivers should they need assistance with commitment to ASCO, their hospital community Published in numerous medical journals and more
the financial arrangements for their care. and the patients they serve for at least 20 years. than 125 publications dedicated to oncology and
CTCA maintains contracts with many major Prior to joining CTCA, Dr. Markman served as the women’s health, Dr. Schink has also authored more
national and regional insurance companies, Vice President for Clinical Research and Chairman of than 10 chapters in oncology textbooks, focusing
employers and other health care companies that the Department of Gynecologic Medical Oncology much of his academic work on gestational
have approved patient access to CTCA hospitals. We at MD Anderson Cancer Center in Houston. Prior trophoblastic disease. He served as principal
treat patients who have both in-network and out-of- to that, he served as Chair of the Department of investigator and co-investigator for many clinical
network benefits with these carriers. Hematology/Oncology and Director of the Taussig trials responsible for improving and expanding
Cancer Center at the Cleveland Clinic Foundation, cancer treatment options.
and Vice Chair of the Department of Medicine at Additionally, Dr. Schink serves as Chief of
Memorial Sloan-Kettering Cancer Center in New York. Gynecologic Oncology for CTCA, Medical Director
Dr. Markman received his MD from New York of Gynecologic and Medical Oncology and Senior
University. Vice President of Clinical Affairs for CTCA Chicago.
Dr. Schink received his MD from The University of
Texas at San Antonio.
4 CTCA Patient Treatment Results 2019 | 2020 ABOUT THIS REPOR T 5
CTCA Patient Demographics CTCA Patient Demographics
JULY 1, 2017 - JUNE 30, 2018 JULY 1, 2017 - JUNE 30, 2018
New Patients BY GENDER New Patients BY AGE GROUP
Analytic and Non-Analytic Analytic and Non-Analytic
Patient demographics are based on data provided by the tumor registry from July 1, 2017 - June 30, 2018.
90+ 15 Types New Patients1 ANALYTIC AND Cancer Types BY STAGE
New
New Patients
Patients11 ANALYTIC
ANALYTIC AND
AND Cancer
Cancer Types BYBY STAGE
STAGE New
NewPatients
PatientsBY
BY GENDER
2GENDER New
New Patients
Patients BY
BY AGE
AGE GROUP
GROUP
4,080
NONANALYTIC22
NONANALYTIC 80-89
Analytic 224
AnalyticPatients
PatientsOnly
Only 44%% 176
176 NONANALYTIC
Analytic
Analyticand
andNon-Analytic
Non-Analytic
Analytic
Analytic
Patients
Analyticand
Only
andNon-Analytic
Non-Analytic 4% 176
44% 1,067 Unknown
Male
70-79
261
261 77%% Unknown
Unknown 261 7%
9,192 60-69 2,862
5,150 3% 119
5,150
5,150 5,112 N/A
N/A
50-59 33%% 119
119 3,021
4,080
4,080
90+
90+
N/A 15
15
56
56%% 56% 1,383 Non- 56% 80-89
80-89
1,184 29% 224
224 Stage 0
Non-
Non- 1,1,1184
40-49
84 29 Stage
Stage00 44
44%% 4,042 1,067
1,067 20%
Analytic
Analytic 4,042
4,042
Female 30-39 29 482
%% 20
20%% 807
807
Analytic
Male
Male
44%
70-79
70-79
Stage IV 807
Patients
Patients 44
44%% Analytic
Analytic
Stage
StageIV
18-29
IV
138
Patients
9,192
9,192 Analytic 60-69
60-69 2,862
2,862
Stage 1
3,021
3,021
Patients
Patients 0
Stage
Stage11
500 1000 1500 2000 2500 3000
56
56%%
5,112
5,112
Patients 50-59
50-59
694 17% 20% 801
694
694 17
17%% 20
20%% 801
801 Female
Female
40-49
40-49
Stage III
30-39
30-39 482
482
1,383
1,383
Stage
StageIIIIII Stage II
Stage
StageIIII
18-29
18-29 138
138
00 500
500 1000
1000 1500
1500 2000
2000 2500
2500 3000
3000
New Patients BY CANCER TYPE 3
New Patients BY STATE OR TERRITORY
New
New Patients
Patients
Analytic BY
BY STATE
STATE
and Non-Analytic OR
OR TERRITORY
Patients TERRITORY Analytic and Non-Analytic
Analytic
Analyticand
andNon-Analytic
Non-Analytic
3000 2,879 WA
WA
WA New 53 BY
NewPatients
Patients BY CANCER TYPE33 ND
CANCER TYPE ME
53
53 30.2% ME
ME MT 10
2500 MT
MT ND
ND 10
10 Analytic
Analyticand
andNon-Analytic
Non-AnalyticPatients
Patients
28 20
OR
OR 28
28
2,276
2,276 20
20 VT
VT99 4,612
4,612
OR 2,276 MN VT 9 4,612 NH 6
2,088 MN
MN NH66
NH 43 ID SD 55 WI NY MA 14
2000 43
43 ID
ID SD
SD 55
55 NY
NY MA14
MA 14 3000
3000 41 172
21.9% 41
41 23
23
WI
WI
210
210 172
172 RI22
RI
WY 23 210 MI 2,879
2,879 RI 2
CT 29
WY
WY MI
MI 13 253 PA30.2
IA 30.2%%
2500 628NV
13
13 253
253 PA
PA CT
CT2929 NE NJ 180
1500 IA
IA 753
628
628NV
NV NE
NE 74
74 753
753 NJ
NJ 180
180 2500
45
74
IL IN OH DE 53
62
62 UT
UT 1,06645
45 1,132
IL
825
IL ININ OH
825% 250
250
OH
215
215 DE
DE53
MD
53
MD156
156
2,08862
2,088 UT
14 C0 825 250 215 WV
VA
MD 156
1000 14
14 C0
C0 11.9 WV
WV VA VA 2000 CA
2000 21.9 56 KS MO KY 43 178 DC 12
11.2% KS 21.9 1
CA
CA
207
207
647 56
56 KS
546MO
MO KY
KY 43
43 178
178 1
1
DC
DC1212 207 %%
1,018 113 223 85
500 1,018
1,018
6.8% 166 314
113
113 223
223 85
85
269 188 NC
NC 1500
1500
NC
324
230 5.7%
2.0% 324
324 AZ OK TN 230
AZ 1.7%
AZ 3.3% OK
OK TN
TN230
230
2.8% 398 NM 731 AR 1,132
1,132 SC
0 398
398 NM
NM 2.4
731
731% AR
AR SC
SC 51 1,066
1,066 159 AL GA 193
51
51 1000
1000
950
950
159
159
MS AL
MS AL GA
GA 193
193 950 647
647 11.2
11.2%% MS
11.9
11.9%%
103 407
1,158
407 1,158
103 407
103
1,158 TX 546
546 LA
TX
TX 166
166 314
314 269 188 188
te
6.8
6.8%%
al
LA
LA
ian
ic
500
500 417
h
269
y
5.7%82
st
al
n
r
ng
230
230 5.7
ge
ne
ac
he
at
ta
%
lo
ct
ea
417
417
ar
82
82
re
os
om
Lu
Co
Kid
ha
1.7
1.7%% 2.0
2.0%%FL
Ot
Re
Ov
Br
nc
Pr
3.3
3.3%% 2.8
2.8%%
op
FL
FL AK 2.4
2.4%%
St
314
Pa
Es
AK
AK 314
314 00 25
25
25
1 The overall patient population includes patients evaluated at CTCA. Non-analytic patients are those who received OTHER/UNKNOWN 29
tee
all
riiaan
n
OTHER/UNKNOWN
OTHER/UNKNOWN 29
29 at CTCA due to progressive or
tiicc
acch
h
geea
neey
y
asst
t
taal
l
onn
err
sttaat
ngg
across all CTCA hospitals, including those who received subsequent cancer treatment
thhe
eaat
ollo
ecct
reea
LLuun
haag
idn
ma
vaar
crre
roos
toom
CCo
KKid
OOt
RRe
OOv
BBr
non-cancer directed therapy or received palliative care only. recurrent disease.
opph
annc
PPr
SSt
EEsso
PPa
2 Analytic patients are those who are diagnosed and/or 3 Includes 9,192 patients of which 353 had multiple primary HI
HI
HIof cancer treatment VI 22 PR 1
received all or part of their first course 22sites, equating to 9,525
VI22
VI PR11primary cancers.
PR 23
23
23
6 CTCA Patient Treatment Results 2019 | 2020 ABOUT THIS REPOR T 7
About this Report
Our Length of Life Results 2
Our Quality of Life Results
Our Patient Experience Results
Our Patient Safety and Quality Results
Our Clinical Leadership
Our Research Publications
Stacy F. Our Length of Life Results
LU N G C A N C E R
SECTION 2 SPOTLIGHT
CTCA Chicago
“My medical oncologist talked to Independent Researchers’ Letter • Bert Spilker & Associates, LLC, an
independent health care consulting firm,
me about immunotherapy. I hadn’t Dear Reader: produced the study design for the analyses
We analyzed the data provided by Cancer Treatment and interpretation of the data.
heard of this option before. I soon Centers of America® (CTCA) and the National Cancer
Institute’s Surveillance, Epidemiology, and End • After reviewing data sources, the National
found out that immunotherapy Cancer Institute’s Surveillance, Epidemiology,
Results (SEER) Program database from 2000 through
uses the body’s immune system 2015 for the purpose of compiling survival rates for and End Results (SEER) comparison sample
eleven (11) cancers of interest. Our efforts employed was chosen by matching basic characteristics
to fight cancer cells. I did about six the statistical guidelines that govern these types of (e.g., categories or range of values) on several
analyses by leading practitioners. Although the lack of the most important factors that affect
weeks of immunotherapy, and I of direct comparability of the two data sets imposes survival outcomes.
immediately knew it was working. certain limitations on the interpretation of the results
as stated elsewhere in this publication, we believe • The analyses of both the CTCA and SEER
It’s amazing to me that my own the analyses provide an accurate representation of samples only include cancer patients with
survival rates for CTCA® patients. one of 11 cancer types whose initial diagnosis
body can be used to identify and occurred between 2000 and 2015. The graphs
Sincerely,
on the following pages illustrate the findings.
fight the bad cells. I am still in
Bert Spilker, PhD, MD Chengjie Xiong, PhD
active treatment and continuing
immunotherapy.” BERT SPILKER, PHD, MD
Bert Spilker, PhD, MD, is the founder of Bert Spilker & Associates, LLC (BS&A), a health care consulting company
working with more than 100 health care clients and contracting with over 150 experts on a variety of research
No case is typical. You should not expect areas of specialization.
to experience these results.
Prior to forming BS&A, Dr. Spilker served as the Senior Vice President of Scientific and Regulatory Affairs
for Pharmaceutical Research and Manufacturers of America (PhRMA) based in Washington, D.C. where he
represented the U.S. pharmaceutical industry both nationally and internationally. Dr. Spilker also served as
President and co-founder of Orphan Medical, Inc., a pharmaceutical company that developed and marketed
medical products for patients with orphan/rare diseases.
He currently serves as Clinical Professor of Pharmacy Practice at the University of Minnesota and Adjunct
Professor of Medicine and Clinical Professor of Pharmacy at the University of North Carolina at Chapel Hill.
Dr. Spilker completed his medical training in pharmacology and internal medicine at Cornell Medical College,
State University of New York (Downstate Medical Center), University of California at San Francisco, University of
Miami Medical School (PhD to MD Program) and Brown University Medical School.
CHENGJIE XIONG, PHD, MS
Chengjie Xiong, PhD, MS, studies novel statistical design of experiments and clinical trials, linear and nonlinear
mixed models, longitudinal data analysis, survival analysis and reliability, diagnostic accuracy, advanced
meta-analysis, categorical data analysis, order restricted statistical inferences, and their applications in medicine,
public health, biology, education and engineering.
Dr. Xiong remains active in interdisciplinary research and has provided statistical consulting for academia,
private industries and government agencies across the country, including directing the database management
and statistical analyses for several National Institutes of Health (NIH) funded projects.
He received a BS in Mathematics from Xiangtan University (China), an MS in Applied Mathematics from Peking
University (China), and a PhD in Statistics from Kansas State University.
OUR LENGTH OF LIFE RESULTS 9
METHODOLOGY
For both the CTCA and SEER samples, only cancer The survival curve for each cancer type (defined
patients whose initial diagnosis occurred between as the probability of a cancer patient’s survival as
2000 and 2015 were analyzed. Cancer cases with a function of time from the initial diagnosis) was
missing information on either the date of initial estimated by the Kaplan-Meier nonparametric
diagnosis or date of last contact were deleted product-limit estimator. 1 Three statistical tests were
from the CTCA database because the survival then used to compare the survival curves between
time or censoring time for such patients could the CTCA database and the SEER database.
not be computed. Cancer patients with missing Two of these tests, the log rank test and Wilcoxon
SEER Summary Stages were also excluded from test, are nonparametric and thus, valid to compare
the analyses. For patients with multiple cancers survival curves that have any shapes.1 These tests are
in the SEER and CTCA databases, only the first or different, however, in their sensitivity (or the power)
primary cancer diagnosed was used for the survival to detect survival differences. The log rank test is
comparisons. Patients with a histologic code considered the most sensitive or powerful when the
(ICD-O-3) between 9590 and 9989 were excluded risk or the hazard of death between CTCA and SEER
Statistical Methodology from the analyses because these histologic types samples is approximately proportional, whereas the
are generally not included by SEER for any non- Wilcoxon test tends to be more sensitive when the
hematopoietic cancer types. Patients who did not ratio of hazards of death is higher at earlier times
DATA SELECTION receive treatment from CTCA were also excluded than at later ones. The third test, the likelihood ratio
Two databases were considered for this study. The SEER database was selected to conduct these from the analyses. test, is the most restrictive of the three in the sense
The National Cancer Institute’s Surveillance, analyses because of its comprehensive content The survival outcomes from the SEER database were that it is appropriate to use only for special survival
Epidemiology, and End Results (SEER) Program and access to patient-level data (and because provided by the SEER Limited-Use Data File as the curves (called exponential distributions) whose
database and the National Cancer Database (NCDB). of restrictions imposed on the use of the NCDB number of completed months. These numbers were hazards of death are constant across time.2
The SEER database is an authoritative data set database for comparative analysis and external then converted to the number of years by dividing Ninety-five percent confidence interval (95% CI)
created for use as an epidemiological tool to reporting purposes). the number of total months by 12. Although the estimates for the individual survival rates, as well
monitor the incidence and mortality of cancer The SEER comparison sample was chosen by exact dates for the initial diagnosis and death as the difference in survival rates between the
in the United States. SEER collects patient the categories in categorical factors (e.g., cancer were available in the CTCA database, the CTCA CTCA and SEER samples at specific time points
demographics, tumor characteristics and survival stages) with the CTCA cancer cohort and selecting survival outcomes were computed using the same after diagnosis, were based on the estimated
data from 17 regional registries throughout the U.S., the overlapping ranges in continuous factors methodology as the SEER database; the number of survival curves and the relevant asymptotic normal
representing 28 percent of the U.S. population. (e.g., age at diagnosis) from the CTCA cancer completed months was computed by first dividing distributions. All these analyses were implemented
cohort. These factors affect survival outcomes. the exact days from the initial diagnosis to death, or using the standard SAS package of statistical tests
The NCDB compiles cancer registry data from last contact for those who remained alive, by 365.24
cancer programs in the U.S. and Puerto Rico, The SEER Limited-Use Database (2016) was used (i.e., SAS/PROC LIFETEST).3 Adjusted analyses were
to select the SEER comparison sample. The final (as was done by SEER), then rounding down to the also done (results not shown) using the stratified
capturing approximately 75% of newly diagnosed number of completed months, and finally dividing
cancers in these areas. It includes data on patient survival analyses included only patients from both log rank test and the Wilcoxon test as well as Cox’s
the CTCA and SEER databases whose following the result by 12. For those patients who were still proportional hazards models to compare the
characteristics, tumor staging, tumor histology, alive or lost to follow-up at the time of entering the
type of first treatment, disease recurrence and cancer characteristics were available from the two survival outcomes between the CTCA and SEER
databases: SEER Summary Stages, primary tumor databases, survival time was treated as statistically samples after adjusting for the effects of age at
survival using standardized coding definitions. It is censored at the difference between the date of last
commonly used to guide quality improvement and sites, cancer histologic types, gender and age at diagnosis, gender (except for breast and prostate
initial diagnosis. For example, if a specific SEER contact and the date of initial diagnosis.1 cancers), race, marital status at diagnosis, insurance
pursue investigator-initiated research questions.
The NCDB provides insight into analytic cancer Summary Stage had only patients in one database, status at diagnosis and year of initial diagnosis. The
diagnoses and primary treatments. The main none of these patients was used in the analyses. technical details of these statistical analyses are
limitation of the data is that the cohorts are not To match the age at initial diagnosis, the range (i.e., available from CTCA.
population-based; they are identified from the minimum and maximum ages) was computed for
hospitals at which the patients presented for each sample. Only patients whose age at initial
diagnosis fell into the overlap of the two ranges 1 Kalbfleisch JD, Prentice RL. The Statistical Analysis of Failure Time Data. New York: John Wiley, 1980.
diagnosis and/or treatment.
from the CTCA and SEER samples were included in 2 Lawless JF. Statistical Methods and Methods for Lifetime Data, New York: John Wiley & Sons, Inc., 1982.
the comparative survival analyses. 3 SAS Institute Inc., SAS/STAT User’s Guide, Volume 2, Version 6, 1990. Cary, NC, USA.
10 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 11
Length of Life Results
BREAST CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for breast
cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It includes
estimates of the percentage of breast cancer patients with distant (metastatic) disease who survived for six
months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases.
• This analysis included breast cancer patients from CTCA who had primary tumor sites (as coded by
ICD-O-2 (1973+)) from C500 to C509, were diagnosed from 2000 to 2015 (including 2000 and 2015) and
received at least part of their initial course of treatment at CTCA. All patients included in the analysis were
considered analytic patients by CTCA.
• Breast cancer patients with distant (metastatic) disease from the SEER database and breast cancer patients
with distant (metastatic) disease from the CTCA database were included in the analysis. In addition, the
analysis excluded patients whose medical records were missing any of the following information:
– SEER Summary Stages – Date of initial diagnosis
– Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race
BREAST CANCER SURVIVAL RATE
LIMITATIONS
Patients DiagnosedBREAST CANCER(Metastatic)
with Distant SURVIVAL Cancer
RATE Between 2000-2015
Direct statistical comparisons of survival outcomes between groups of cancer patients have limitations Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
CTCA (n=788) and SEER* (n=64,690)
because of the possible confounding effects of other factors cited below and elsewhere in this report. CTCA (n=632) and SEER* (n=38,935)
Accordingly, the data appearing in this report should be considered directional, not definitive.
100
First, although a large sample of patients was available from the SEER Program across many geographic
90 94
regions in the U.S., both samples, including the sample from CTCA, are convenience samples. This precludes
the assumption of a causal interpretation of the statistical inferences. Second, although some types of 80 86
Percent of Patients
matching, as described earlier, were implemented to select the appropriate SEER and CTCA comparison 70 75 76
samples, the distributions of important covariates, such as age at initial diagnosis, gender, race, marital 60 66 69
status at diagnosis, insurance status at diagnosis and year of initial diagnosis, were not exactly the same 62
50 57 56
between the CTCA sample and SEER sample. Hence, even with the adjusted analyses, possible confounding 50 50
of these factors to the analyses and results may not be ruled out. Further, many factors (e.g., household 40 43 45
30 38 39 36
income, mobility, etc.) other than those considered in the analyses and available from the databases may 33
have contributed to the actual survival outcomes. As a result of these factors, the possible confounding of 20 29 26 24
the results of these analyses may not be ruled out. Finally, the survival analyses were based on the statistical 10
comparisons of the rate of death from all possible causes, not solely cancer-specific death. These data are
0
not included in the CTCA data set and, therefore, not available for statistical comparison. 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Visit cancercenter.com/ctca-results for further information about the methodology used to calculate the
Years (after initial diagnosis)
CTCA results and read about the analysis limitations.
CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
12 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 13Length of Life Results Length of Life Results
COLON CANCER ESOPHAGEAL CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for colon The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for
cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It includes esophageal cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015.
estimates of the percentage of colon cancer patients with distant (metastatic) disease who survived for six It includes estimates of the percentage of esophageal cancer patients with distant (metastatic) disease who
months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases. survived for six months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases.
• This analysis included colon cancer patients from CTCA who had primary tumor sites (as coded by • This analysis included esophageal cancer patients from CTCA who had primary tumor sites (as coded by
ICD-O-2 (1973+)) from C180 to C189, were diagnosed from 2000 to 2015 (including 2000 and 2015) and ICD-O-2 (1973+)) from C150 to C159, were diagnosed from 2000 to 2015 (including 2000 and 2015) and
received at least part of their initial course of treatment at CTCA. All patients included in the analysis were received at least part of their initial course of treatment at CTCA. All patients included in the analysis were
considered analytic patients by CTCA. considered analytic patients by CTCA.
• Colon cancer patients with distant (metastatic) disease from the SEER database and colon cancer patients • Esophageal cancer patients with distant (metastatic) disease from the SEER database and esophageal
with distant (metastatic) disease from the CTCA database were included in the analysis. In addition, the cancer patients with distant (metastatic) disease from the CTCA database were included in the analysis.
analysis excluded patients whose medical records were missing any of the following information: In addition, the analysis excluded patients whose medical records were missing any of the following
information:
– SEER Summary Stages – Date of initial diagnosis
– Primary tumor sites – Age at initial diagnosis – SEER Summary Stages – Date of initial diagnosis
– Cancer histologic types – Gender & Race – Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race
COLON CANCER SURVIVAL RATE ESOPHAGEAL CANCER SURVIVAL RATE
Patients Diagnosed COLON
with CANCER SURVIVAL Cancer
Distant (Metastatic) RATE Between 2000-2015 ESOPHAGEAL
Patients Diagnosed CANCER
with Distant SURVIVAL
(Metastatic) RATE
Cancer Between 2000-2015
Patients Diagnosed with Distant
CTCA (n=788) (Metastatic)
and SEER* Cancer Between 2000-2015
(n=64,690) Patients Diagnosed
CTCA (n=788) and SEER* (n=64,690) 2000-2015
with Distant (Metastatic) Cancer Between
CTCA (n=788) and SEER* (n=64,690) CTCA (n=291) and SEER* (n=15,311)
100 100
90 90
80 87 80
Percent of Patients
Percent of Patients
70 70
71
60 64 60 64
50 54 50
51
40 44 40 47
40 38
30 34 30
31 28
20 25 20 26
21 20 17 20
10 16 15 15 13 10 16 6 7 5 6 5 6 4 4 4
12 12 13 11 11 8
0 0 8
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years (after initial diagnosis) Years (after initial diagnosis)
CTCA SEER CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes. *The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors. sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
14 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 15Length of Life Results Length of Life Results
KIDNEY CANCER NON–SMALL CELL LUNG CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for kidney The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for
cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It includes non-small cell lung cancer patients with distant (metastatic) disease who were diagnosed between 2000
estimates of the percentage of kidney cancer patients with distant (metastatic) disease who survived for six and 2015. It includes estimates of the percentage of non-small cell lung cancer patients with distant (meta-
months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases. static) disease who survived for six months to five years after the initial diagnosis, as recorded in the CTCA®
and SEER databases.
• This analysis included kidney cancer patients from CTCA who had primary tumor site (as coded by
ICD-O-2 (1973+)) of C649, were diagnosed from 2000 to 2015 (including 2000 and 2015) and received at • This analysis included non-small cell lung cancer patients from CTCA who had primary tumor sites (as
least part of their initial course of treatment at CTCA. All patients included in the analysis were considered coded by ICD-O-2 (1973+)) from C340 to C343 or from C348 to C349, were diagnosed from 2000 to
analytic patients by CTCA. 2015 (including 2000 and 2015) and received at least part of their initial course of treatment at CTCA. All
• Kidney cancer patients with distant (metastatic) disease from the SEER database and kidney cancer patients patients included in the analysis were considered analytic patients by CTCA.
with distant (metastatic) disease from the CTCA database were included in the analysis. In addition, the • Non-small cell lung cancer patients with distant (metastatic) disease from the SEER database and non-small
analysis excluded patients whose medical records were missing any of the following information: cell lung cancer patients with distant (metastatic) disease from the CTCA database were included in the
analysis. In addition, the analysis excluded patients whose medical records were missing any of the
– SEER Summary Stages – Date of initial diagnosis following information:
– Primary tumor sites – Age at initial diagnosis
– SEER Summary Stages – Date of initial diagnosis
– Cancer histologic types – Gender & Race
– Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race
KIDNEY CANCER SURVIVAL RATE NONSMALL CELL LUNG CANCER SURVIVAL RATE
KIDNEY CANCER(Metastatic)
SURVIVALCancerRATE Between 2000-2015
Patients Diagnosed with Distant PatientsNON-SMALL
Diagnosed withCELL LUNG CANCER SURVIVAL RATE
Distant (Metastatic) Cancer Between 2000-2015
Patients Diagnosed with Distant
CTCA (n=788) (Metastatic)
and SEER* Cancer Between 2000-2015
(n=64,690) Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
CTCA (n=788) and SEER* (n=64,690)
CTCA (n=228) and SEER* (n=20,824) CTCA (n=2,336) and SEER* (n=283,704)
100 100
90 90
80 80
Percent of Patients
Percent of Patients
70 70
70 68
60 60
50 50
51 49
40 40 47
30 36 37 30 39
34
20 27 29
22 25 20 24 25
18 21 19 19
10 16 14 17 16 15 10 16 15 7 6 5 8 7
12 11 10 12 12 4 4
9 10
0 0
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years (after initial diagnosis) Years (after initial diagnosis)
CTCA SEER CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes. *The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors. sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
16 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 17Length of Life Results Length of Life Results
SMALL CELL LUNG CANCER OVARIAN CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for small The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for ovarian
cell lung cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It includes
includes estimates of the percentage of small cell lung cancer patients with distant (metastatic) disease who estimates of the percentage of ovarian cancer patients with distant (metastatic) disease who survived for six
survived for six months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases. months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases.
• This analysis included small cell lung cancer patients from CTCA who had primary tumor sites (as coded • This analysis included ovarian cancer patients from CTCA who had primary tumor site (as coded by
by ICD-O-2 (1973+)) from C340 to C343 or from C348 to C349, were diagnosed from 2000 to 2015 ICD-O-2 (1973+)) of C569, were diagnosed from 2000 to 2015 (including 2000 and 2015) and received at
(including 2000 and 2015) and received at least part of their initial course of treatment at CTCA. All least part of their initial course of treatment at CTCA. All patients included in the analysis were considered
patients included in the analysis were considered analytic patients by CTCA. analytic patients by CTCA.
• Small cell lung cancer patients with distant (metastatic) disease from the SEER database and small cell • Ovarian cancer patients with distant (metastatic) disease from the SEER database and ovarian cancer
lung cancer patients with distant (metastatic) disease from the CTCA database were included in the patients with distant (metastatic) disease from the CTCA database were included in the analysis. In
analysis. In addition, the analysis excluded patients whose medical records were missing any of the addition, the analysis excluded patients whose medical records were missing any of the following
following information: information:
– SEER Summary Stages – Date of initial diagnosis – SEER Summary Stages – Date of initial diagnosis
– Primary tumor sites – Age at initial diagnosis – Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race – Cancer histologic types – Gender & Race
SMALL CELL LUNG CANCER SURVIVAL RATE OVARIAN CANCER SURVIVAL RATE
SMALL CELL LUNG CANCER SURVIVAL RATE OVARIAN CANCER SURVIVAL RATE
Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015 Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015 Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
CTCA (n=788) and SEER* (n=64,690)
CTCA (n=349) and SEER* (n=56,817)
CTCA (n=788) and SEER* (n=64,690)
CTCA (n=237) and SEER* (n=40,893)
100 100
90 90 95
80 80 88
79 78
Percent of Patients
Percent of Patients
70 76 70
71
60 60 63 66
61
50 50 56 54
49 49
40 45 40 43 43
40 38 38
30 30 34 32
30 27
20 20
21 21
10 7 5 6 4 4 4 4 4 10
11 13 9 3 3 3 3
0 0
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years (after initial diagnosis) Years (after initial diagnosis)
CTCA SEER CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes. *The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors. sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
18 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 19Length of Life Results Length of Life Results
PANCREATIC CANCER PROSTATE CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for
pancreatic cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. prostate cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015.
It includes estimates of the percentage of pancreatic cancer patients with distant (metastatic) disease who It includes estimates of the percentage of prostate cancer patients with distant (metastatic) disease who
survived for six months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases. survived for six months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases.
• This analysis included pancreatic cancer patients from CTCA who had primary tumor sites (as coded by • This analysis included prostate cancer patients from CTCA who had primary tumor site (as coded by
ICD-O-2 (1973+)) from C250 to C254 or from C257 to C259, were diagnosed from 2000 to 2015 (including ICD-O-2 (1973+)) of C619, were diagnosed from 2000 to 2015 (including 2000 and 2015) and received at
2000 and 2015) and received at least part of their initial course of treatment at CTCA. All patients included least part of their initial course of treatment at CTCA. All patients included in the analysis were considered
in the analysis were considered analytic patients by CTCA. analytic patients by CTCA.
• Pancreatic cancer patients with distant (metastatic) disease from the SEER database and pancreatic cancer • Prostate cancer patients with distant (metastatic) disease from the SEER database and prostate cancer
patients with distant (metastatic) disease from the CTCA database were included in the analysis. In addition, patients with distant (metastatic) disease from the CTCA database were included in the analysis. In addition,
the analysis excluded patients whose medical records were missing any of the following information: the analysis excluded patients whose medical records were missing any of the following information:
– SEER Summary Stages – Date of initial diagnosis – SEER Summary Stages – Date of initial diagnosis
– Primary tumor sites – Age at initial diagnosis – Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race – Cancer histologic types – Gender & Race
PANCREATIC CANCER SURVIVAL RATE PROSTATE CANCER SURVIVAL RATE
PANCREATIC CANCER
Patients Diagnosed with Distant SURVIVAL
(Metastatic) RATEBetween 2000-2015
Cancer PROSTATE CANCER
Patients Diagnosed with Distant SURVIVAL
(Metastatic) RATE Between 2000-2015
Cancer
Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015 Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
CTCA (n=788) and SEER* (n=64,690) CTCA (n=788) and SEER* (n=64,690)
CTCA (n=1,555) and SEER* (n=64,946) CTCA (n=321) and SEER* (n=34,487)
100 100
90 90 97
90
80 80 85 82
Percent of Patients
Percent of Patients
70 70 73 74
60 60 65
58 61 58
50 50
52 49
40 40 45 43
30 30 39 37
32 34 35
28 31
20 20 27 25
10 18 8 7 10
14 11 6 4 6 3 5 3 4 3 3 2 3 2
0 0
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years (after initial diagnosis) Years (after initial diagnosis)
CTCA SEER CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes. *The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors. sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
20 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 21Length of Life Results Length of Life Results
RECTAL CANCER STOMACH CANCER
The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for rectal The chart below reflects the Cancer Treatment Centers of America® (CTCA) and SEER survival rates for
cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015. It includes stomach cancer patients with distant (metastatic) disease who were diagnosed between 2000 and 2015.
estimates of the percentage of rectal cancer patients with distant (metastatic) disease who survived for six It includes estimates of the percentage of stomach cancer patients with distant (metastatic) disease who
months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases. survived for six months to five years after the initial diagnosis, as recorded in the CTCA® and SEER databases.
• This analysis included rectal cancer patients from CTCA who had primary tumor site (as coded by ICD-O-2 • This analysis included stomach cancer patients from CTCA who had primary tumor sites (as coded by
(1973+)) of C209, were diagnosed from 2000 to 2015 (including 2000 and 2015) and received at least part ICD-O-2 (1973+)) from C160 to C169, were diagnosed from 2000 to 2015 (including 2000 and 2015) and
of their initial course of treatment at CTCA. All patients included in the analysis were considered analytic received at least part of their initial course of treatment at CTCA. All patients included in the analysis were
patients by CTCA. considered analytic patients by CTCA.
• Rectal cancer patients with distant (metastatic) disease from the SEER database and rectal cancer patients • Stomach cancer patients with distant (metastatic) disease from the SEER database and stomach cancer
with distant (metastatic) disease from the CTCA database were included in the analysis. In addition, the patients with distant (metastatic) disease from the CTCA database were included in the analysis. In addition,
analysis excluded patients whose medical records were missing any of the following information: the analysis excluded patients whose medical records were missing any of the following information:
– SEER Summary Stages – Date of initial diagnosis – SEER Summary Stages – Date of initial diagnosis
– Primary tumor sites – Age at initial diagnosis – Primary tumor sites – Age at initial diagnosis
– Cancer histologic types – Gender & Race – Cancer histologic types – Gender & Race
RECTAL CANCER SURVIVAL RATE STOMACH CANCER SURVIVAL RATE
Patients Diagnosed with CANCER
RECTAL SURVIVAL Cancer
Distant (Metastatic) RATE Between 2000-2015 STOMACH CANCER
Patients Diagnosed with Distant SURVIVAL
(Metastatic) RATE Between 2000-2015
Cancer
Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015 Patients Diagnosed with Distant (Metastatic) Cancer Between 2000-2015
CTCA (n=788) and SEER* (n=64,690) CTCA (n=788) and SEER* (n=64,690)
CTCA (n=243) and SEER* (n=15,179) CTCA (n=372) and SEER* (n=22,990)
100 100
90 90
80 88 80
77
Percent of Patients
Percent of Patients
70 74 70
60 60 66
50 59 59 50
40 47 48 40 44
30 37 39 30 34
20 29 28 20 25
24
20 20 19 16
10 15 16 13 14 13 12 10
11 11 6 7 5 6 4 5 5 4
9 9 3 3
0 0
0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Years (after initial diagnosis) Years (after initial diagnosis)
CTCA SEER CTCA SEER
*The SEER data represent national results over a large number of institutions and have been included for illustrative purposes. *The SEER data represent national results over a large number of institutions and have been included for illustrative purposes.
They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the They are not intended to represent a controlled study and/or a perfect analysis of the CTCA data because of variability in the
sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors. sample sizes of the two databases, the clinical condition(s) of the patients treated and other factors.
22 CTCA Patient Treatment Results 2019 | 2020 OUR LENGTH OF LIFE RESULTS 23About this Report
Our Length of Life Results
Our Quality of Life Results 3
Our Patient Experience Results
Our Patient Safety and Quality Results
Our Clinical Leadership
Our Research PublicationsScott D. Our Quality of Life Results
CO LO R E C TA L C A N C E R
SECTION 3 SPOTLIGHT
CTCA Atlanta
Assessment Background and Methodology • CTCA measures and intervenes on
“My oncologist was caring and 27 different indicators of quality of
passionate about us working life (symptoms and activities of daily
Cancer Treatment Centers of America® (CTCA) was life) for treating patients.
as a team to treat and fight among the first U.S. cancer hospitals to use quality of
life metrics as part of its routine assessment of patient • Between July 1, 2017 and June 30,
my cancer. Most importantly, well-being and quality of care. Research demonstrates 2019, more than 8,692 patients
he listened to me. I learned Patient Self-Reported Outcome (PSRO) data are a completed both baseline and
valuable part of a patient’s treatment plan. Several return self-assessments.
that cancer affects the whole studies validate the potential of routine assessment data
in improving both the precision and degree of patient- • Graphs on pages 27-31 reflect a
person, not just the organ(s), change in score for patients by
centered care – making sure the right care is delivered
and CTCA has offerings to help. to the right patients at the right time. The benefits cancer type who self-reported at
of PSRO data not only include better health-related least one symptom as severe at
I took advantage of nutrition, baseline in comparison to their
quality of life and fewer emergency room visits, but also
return visit.
emotional and psychological improvements in health service outcomes and survival.1,2,3
support, and acupuncture.” CTCA® patients self-report their symptoms and quality • Graphs on pages 32 and 33 reflect
of life concerns as part of our patient evaluation CTCA aggregate and facility patient
process. This process includes a symptom assessment, self-reported outcome data for five
called the Symptom Inventory Tool (SIT), that patients (5) key areas across cancer types.
complete in correspondence with their treatment cycle,
not more frequently than every 21 days. Upon arrival,
patients complete the electronically administered SIT
using a tablet computer. CTCA team members utilize
these results as part of their patient assessment and
evaluation process. These two complementary processes
(patient self-assessment and reflection, and analyzing
the data as a starting point for discussion) help CTCA
care teams readily identify when patients may benefit
from referral and/or more directed intervention to help
them cope with their symptoms, side effects and quality
of life concerns. The data also exist real-time within
the electronic health record. More than 94 percent of
patients voluntarily participate in the SIT assessments.
1 Basch E, Deal AM, Kris MG, et al: Symptom monitoring with
patient-reported outcomes during routine cancer treatment: A
randomized controlled trial. J Clin Oncol 10.1200/JCO.2015.63.0830.
2 Jensen R, Snyder CF: PRO-cision Medicine: Personalizing Patient
Care Using Patient-Reported Outcomes. J Clin Oncol 10.1200/
JCO.2015.63.0830.
3 Snyder CF, Herman JM, White SM, et al: When using patient-
reported outcomes in clinical practice, the measure matters: A
randomized controlled trial. J Oncol Pract 10:e299-e306, 2014.
OUR QUALIT Y OF LIFE RESULTS 25You can also read
