· Web viewFlorida Hospital Cancer Institute Melvin Field, MD Neurosurgical Director – Gamma Knife Center and Neuroscience Institute The FHCI Brain and Spine Program specializes

Florida Hospital Cancer Institute2018 Annual Outcomes Report

BRAIN AND SPINE ONCOLOGY

Herbert B. Newton, MD, FAANMedical Director, Brain and Spine Tumor ProgramFlorida Hospital Cancer Institute

Melvin Field, MDNeurosurgical Director – Gamma Knife Centerand Neuroscience Institute

The FHCI Brain and Spine Program specializes in the diagnosis and comprehensive management of primary brain and spinal tumors for adult and pediatric patients, complications of malignant/low-grade brain and spinal tumors, secondary metastatic cancer directly affecting the brain and spinal cord, neurologic manifestations of cancers elsewhere in the body, and treatment-related complications affecting the central and peripheral nervous system.

Among the advanced treatments used in the Brain and Spine Program is the Leksell Gamma Knife® Perfexion radiosurgery system. The non-invasive outpatient procedure is used to treat malignant and benign brain tumors while leaving surrounding tissue intact. Florida Hospital Orlando is the only facility in Central Florida that offers Gamma Knife radiosurgery. It has treated almost 3,000 patients since the Gamma Knife Center opened in 1996.

For more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

Brain and Spine Cancer CasesFive-Year Survival Cases Diagnosed 2007-2013

A comparison of observed survival rates for brain and spinal tumors demonstrates a significantly higher five-year survival for FHCI patients when compared with the national average.

Florida Hospital SEER0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%73.25%

34.90%

FHCI Tri-county vs. nine SEER registries (SEER = surveillance, epidemiology and end-results) Sources: FHCI Cancer Registry; seer.gov CanQues

BREAST ONCOLOGY

Louis Barr, MDMedical Director, Florida Hospital Cancer InstituteChair, Breast Program Leadership

As a leader in breast cancer treatment, FHCI employs a wide range of therapies, including surgery, radiation therapy, chemotherapy, hormonal therapy and targeted therapy. Our multidisciplinary approach provides comprehensive care that enables patients to coordinate appointments with different specialists within the same day and promptly receive coordinated treatment recommendations. Breast cancer care coordinators assist patients through every step of their treatments and offer moral support. After-care and support help patients transition back to their day-to-day lives. FHCI is an innovator in community outreach that has provided thousands of screenings to underserved women.


Breast Cancer CasesAge at Diagnosis by Gender

Approximately 54 percent of all female breast cancer patients at FHCI were diagnosed between ages 50 and 69. About 6 percent were under age 40 at diagnosis.

Female Patients

20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

50

100

150

200

250

7

47

124

235 230

151

60

8

Chart Title

Age Range

Source: FHCI Cancer Registry

Male Patients

20 29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

1

2

3

4

5

6

7

0

1 1 1

6

2

0 0

Age Range


2016 Breast Cancer CasesFor more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

Stage at Diagnosis by Gender

At FHCI, 873 new cases of breast cancer were diagnosed or treated. Nearly 80 percent of them were identified in early stages (0, I, II), demonstrating the continued effectiveness of building awareness through early screenings.

AJCC STAGE AT DIAGNOSIS Male Female

TOTAL VALUES

NBR

(%)

NBR

(%)

NBR

(%)

0 1 1 96 99 9711.1

1A 20.6

317

99.4

319

36.5

1B 0 0 22100 22 2.5

2A 42.4

160

97.6

164

18.8

2B 0 0 92100 92

10.5

3A 0 0 42100 42 4.8

3B 18.3 11

91.7 12 1.4

3C 27.1 26

92.9 28 3.2

4 0 0 32100 32 3.7

88 0 0 1100 1 0.1

99 0 0 50100 50 5.7

ANY OTHERS 17.1 13

92.9 14 1.6

OVERALL TOTALS 11

1.3

862

98.7

873

100


First-course Surgery TypeBy Stage at Diagnosis

Mastectomy was most often the first course of treatment for breast tumors in stage II, as where lumpectomy or no surgery was more likely the course of treatment chosen in stage I and below.

CROSS-TABULATION OF SUMMARY AJCC STAGE GROUP BY CANCER DIRECTED SURGERY CODE FOR ALL-2015-ANA-BREAST


TYPE OF SURGERY → NONE LUMPECTOMY MASTECTOMY TOTAL VALUESAJCC STAGE AT DIAGNOSIS ↓ NBR (%) NBR (%) NBR (%) NBR (%)

0 4 4.1 55 56.7 38 39.2 97 11.11A 14 4.4 218 68.3 86 27 319 36.51B 0 0 16 72.7 6 27.3 22 2.52A 15 9.1 70 42.7 79 48.2 164 18.82B 8 8.7 37 40.2 47 51.1 92 10.53A 5 11.9 6 14.3 31 73.8 42 4.83B 2 16.7 2 16.7 8 66.7 12 1.43C 2 7.1 5 17.9 21 75 28 3.24 29 90.6 1 3.1 2 6.3 32 3.7

NOT APPLICABLE THIS MORPHOLOGY 1 100 0 0 0 0 1 0.1UNKNOWN STAGE 22 44 12 24 16 32 50 5.7

ANY OTHERS 0 0 6 42.9 8 57.1 14 1.6 OVERALL TOTALS 102 11.7 428 49 342 39.2 873 100


Breast Cancer Five-year Survival Cases Diagnosed 2007-2013Five-year survival rates at FHCI exceeded those of nine surveillances, epidemiology and end-results (SEER) registries.


88.00%

90.00%

92.00%

94.00%

96.00%

98.00%

100.00%

98.46%

91.00%

FHCI Tri-county area vs. nine SEER registries (SEER = surveillance, epidemiology and end-results)Sources: FHCI Cancer Registry; SEER.gov CanQues

GASTROINTESTINAL, PANCREATIC AND HEPATOBILIARY ONCOLOGY

Ahmed Zakari, MDMedical Director, Gastrointestinal Cancer ProgramFlorida Hospital Cancer InstituteChief of Hematology/Oncology Division, Florida HospitalAssistant Professor, University of Central Florida College of Medicine


Matthew Albert, MDMedical Director, Colon and Rectal SurgeryFlorida Hospital Cancer InstituteDirector, Florida Hospital Colorectal Fellowship Program

Juan Pablo Arnoletti, MD, FACSChief of Surgical OncologyChairman of the Gastrointestinal Cancer Leadership CommitteeFlorida Hospital Cancer InstituteProfessor of Surgery, University of Central Florida College of Medicine

FHCI offers a comprehensive array of treatments and therapies for gastrointestinal cancer, including innovative, minimally invasive surgeries and stereotactic body radiation for early or small tumors and radioembolization therapy for large or multiple tumors. The Gastrointestinal, Pancreatic and Hepatobiliary Oncology team uses 3-D technology to produce a more accurate diagnosis. FHCI is committed to education and treatment that improves the lives of our patients and their families, including support to manage the emotional impact of cancer.

Liver and Pancreatic Cancer Cases

Analytical Non-analytical TotalLiver 155 37 192

Pancreatic 311 64 375Total number of liver and pancreas cases for 2016


Colorectal Cancer CasesAge at Diagnosis by Gender

In 2016, male and female patients diagnosed at FHCI with colorectal cancer were most likely to be 60 to 69 years old.


10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90 - 990

10

20

30

40

50

60

70

80

90

100

3 1

14

29

54

88

77

29

31 3

11

23

45

70

54

28

11

Male Female

Age Range

Source: FHCI Cancer RegistryColorectal Cancer CasesStage at Diagnosis by Age

Due to the growing popularity of early screenings, patients were most commonly diagnosed with colorectal cancer at FHCI while in stage I of the disease.

AGE AT DIAGNOSIS → 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-99

ALL OTHER

S

TOTAL VALUE

SAJCC STAGE AT DIAGNOSIS ↓

0 0 0 1 9 9 5 3 0 0 271 1 3 10 19 40 25 8 0 1 1072 0 1 0 0 0 0 0 0 0 1

2A 0 2 5 11 19 26 12 3 0 782B 0 0 1 0 5 5 2 0 0 132C 0 0 0 3 4 1 4 2 0 143 0 1 1 0 0 0 0 0 1 3

3A 0 0 2 5 8 7 1 1 0 243B 1 7 9 14 25 27 7 2 0 923C 0 3 1 7 12 7 5 1 0 364 0 1 0 2 2 2 0 0 0 7

4A 0 3 9 10 7 8 5 0 0 424B 0 2 4 6 14 4 2 3 0 3399 2 2 9 13 13 14 8 2 2 65

ANY OTHERS 0 0 0 0 0 0 0 0 0 2

OVERALL TOTALS 4 25 52 99 158 131 57 14 4 544For more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information


Colorectal Cancer Five-year SurvivalCases Diagnosed 2007-2013

Patients treated for colorectal cancer at FHCI were more likely to survive beyond five years when compared with nine national SEER registries.


30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

71.71%

66.30%

FHCI Tri-County vs. nine SEER registries (SEER = surveillance, epidemiology and end-results).Sources: FHCI Cancer Registry; SEER.gov CanQues

GYNECOLOGIC ONCOLOGY

Robert W. Holloway, MD, DHc, FACOG, FACSMedical Director, Gynecologic Oncology ProgramFlorida Hospital Cancer Institute


Professor of Obstetrics & Gynecology, University of Central FloridaClinical Professor of Obstetrics & Gynecology, Florida State University

James E. Kendrick, MD, FACOGDirector of Clinical OperationsGynecologic Oncology ProgramFlorida Hospital Cancer InstituteAssociate Professor of Obstetrics & Gynecology, University of Central FloridaClinical Associate Professor of Obstetrics & Gynecology, Florida State University

Sarfraz Ahmad, PhD, FABAP, FACBDirector of Clinical Research, Gynecologic OncologyFlorida Hospital Cancer InstituteProfessor of Medical Education, University of Central FloridaProfessor of Clinical Sciences, Florida State University

The Florida Hospital Gynecologic Oncology (FHGO) Program at FHCI is internationally recognized for excellence in clinical research, innovation in robotic surgery and treatment, and novel collaborative laboratory investigations of translational research. Surgeons from around the world have attended Florida Hospital’s advanced robotic training courses and physician observations. FHGO’s seminal research publications, which focus on robotic surgery outcomes, are widely quoted in peer-reviewed scholarly literature. Patients have access to the most advanced oncologic therapies because of affiliations with the National Cancer Institute’s Gynecologic Oncology Group (GOG), several university research centers and industry-sponsored research consortiums.

Cervical Cancer CasesAge at Diagnosis

About 65 percent of patients diagnosed with cervical cancer at FHCI in 2016 were 30 to 59 years old. The disease was infrequently diagnosed in patients younger than 30.


20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

2

4

6

8

10

12

14

16

4

1415

13

10

6

1 1

Chart Title

Age Range


Cervical Cancer CasesStage at DiagnosisNearly 24 percent of cervical cancer patients were diagnosed at stage III of the disease.


I II III IV UNKNOWN0

2

4

6

8

10

12

14

16

0

6

15

11

6

Stage


Cervical Cancer Five-year SurvivalCases Diagnosed 2007-2013

The five-year survival rate for cervical cancer patients treated at Florida Hospital exceeded that measured in nine national cancer registries.

SEER Florida Hospital20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

68.80%

73.41%

FHCI Tri-County vs. nine SEER registries (SEER = surveillance, epidemiology and end-results)Source: FHCI Cancer Registry, SEER.gov CanQues

Ovarian Cancer CasesAge at Diagnosis

Of ovarian cancer patients diagnosed at FHCI in 2016, 50 percent were between ages 60 to 79.


10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

5

10

15

20

25

30

32 2

14

21

2728

11

2

Age Range


Ovarian Cancer CasesStage at Diagnosis

In 2016, ovarian cancer was most frequently diagnosed in the late stages. About 51 percent of 109 ovarian cancer patients were diagnosed with advance stage III disease.For more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

I II III IV UNK0

10

20

30

40

50

60

21

12

56

14

6

Stage


Ovarian Cancer Five-year SurvivalCases Diagnosed 2007-2013

The five-year survival rate for ovarian cancer patients treated at Florida Hospital significantly exceeded that measured in nine national cancer registries.


10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%64.92%

46.70%


Uterine Cancer CasesAge at Diagnosis


About 36 percent of patients diagnosed with uterine cancer at FHCI in 2016 were ages 60 to 69, making this the most common age range for this type of cancer. Another 25 percent were diagnosed between the ages of 70 to 79.

20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

20

40

60

80

100

120

16

24

68

112

76

21

2

Age Range


Uterine Cancer CasesStage at Diagnosis

Because of the popularity of uterine cancer screenings, 60 percent of all patients diagnosed at FHCI in 2016 were in stage I of the disease, which increases their likelihood of survival.

0 I II III IV Unknown0

20

40

60

80

100

120

140

160

180

200

1

186

13

60

24 26

Stage


Uterine Cancer Five-year SurvivalCases Diagnosed 2007-2013


The five-year survival rate for patients with uterine cancer treated at FHCI was about equal to those measured by nine national cancer registries.

Florida Hospital SEER

83.74% 82.80%


Gynecologic Cancer Five-year SurvivalCases Diagnosed 2007-2013

Five-year survival rates for patients with gynecologic cancer treated at FHCI exceeded those measured by nine national cancer registries.


30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

77.54%73.73%

Gynecological = cervical, uterine and ovarianFHCI Tri-County vs. nine SEER registries (SEER = surveillance, epidemiology and end-results)Source: FHCI Cancer Registry, SEER.gov CanQues

HEAD AND NECK ONCOLOGY

Henry Ho, MD Co-Director, Head and Neck Cancer Program


Florida Hospital Cancer InstitutePresident, The Ear, Nose, Throat and Plastic Surgery Associates, PAAssociate Professor, Otolaryngology, University of Central Florida College of MedicineAssociate Professor, Surgery, Florida State University College of Medicine

J. Scott Magnuson, MDCo-Director, Head and Neck Cancer ProgramFlorida Hospital Cancer InstituteChief Medical Officer, Florida Hospital Nicholson CenterProfessor of Otolaryngology Head and Neck Surgery, University of Central Florida College of MedicineMedical Director, Head and Neck Surgery, Celebration HeathDirector, Robotic Head and Neck Surgery, Florida Hospital Nicholson Center for Robotic SurgeryFlorida Hospital Nicholson Center Global Faculty Board Member

Physicians at the FHCI Head and Neck Cancer Program treat more head and neck cancer cases than any other care center in Florida. Our multidisciplinary approach, supported by video-conferenced tumor boards and biannual journal clubs, ensures that patients receive leading-edge, evidenced-based care. Our team offers a complete array of diagnostic and therapeutic options, from free-flap reconstruction and minimally invasive skull base surgery to the latest in chemoradiation therapy and clinical trials. As a leader with a visionary approach to cancer care, the Head and Neck Cancer Program consistently strives to improve patient care and treatment outcomes.

Head and Neck Cancer CasesSite by Gender


At FHCI in 2016, women were nearly four times more likely to be diagnosed with thyroid cancer, the most common type of head and neck cancer. Other head and neck cancers affected men more frequently.

Site MaleFemal

e TotalTHYROID GLAND 48 183 231TONSIL 50 3 53LARYNX 36 7 43SKIN 20 11 31BASE OF TONGUE 27 3 30OTHER PARTS OF TONGUE 19 8 27PAROTID GLAND 10 7 17LYMPH NODES 9 5 14FLOOR OF MOUTH 9 2 11OROPHARYNX 9 2 11OTHER/UNSPECIFIED PARTS OF MOUTH 7 3 10OTHER ORAL CAVITY 6 3 9NASOPHARYNX 3 3 6LIP 3 1 4HYPOPHARYNX 4 0 4NASAL CAVITY & MIDDLE EAR 0 4 4GUM 0 3 3PALATE 2 1 3CONNECTIVE SUBCUTANEOUS OTHER SOFT TISSUE 3 0 3OTHER SALIVARY GLANDS 2 0 2ACCESSORY SINUSES 1 1 2PYRIFORM SINUS 1 0 1TRACHEA 0 0 0


Head and Neck Cancer CasesAge by Gender at Diagnosis


Overall, men were only slightly more likely to be diagnosed with head and neck cancer than women. Women were generally diagnosed at an earlier age than men.

10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90 - 990

10

20

30

40

50

60

70

80

90

100

1 412

29

66

88

47

19

52

2230

5460

48

26

82

MALE FEMALE

Age Range


Head and Neck CancersFive-year SurvivalCases Diagnosed 2007-2013

Five-year survival rates for head and neck cancer at FHCI exceeded the averages of nine national cancer registries.


40.00%

60.00%

80.00%

67.29%65.05%

Head and neck cancers include oral, cavity, pharynx and larynxFHCI Tri-County vs. nine SEER registries (SEER = surveillance, epidemiology and end-results)Sources: FHCI Cancer Registry; SEER.gov CanQues

PEDIATRIC ONCOLOGY


Fouad Hajjar, MDMedical Director, Hematology/OncologyChildren's Center for Cancer and Blood Diseases

David R. Shook, MDMedical Director, Pediatric Bone Marrow TransplantChildren's Center for Cancer and Blood Diseases

The Children’s Center for Cancer and Blood Diseases offers hematology and oncology care for patients with sickle cell disease, thalassemia, bleeding disorders, coagulation problems, various cytopenias, leukemia and other childhood cancers. As a Children’s Oncology Group (COG) affiliate, we can offer leading-edge clinical trials.

Pediatric Cancer Cases Age at Diagnosis by Gender

In 2017, one in about 400 children will be diagnosed with cancer before age 15 (Cancer Facts & Figures, 2014, American Cancer Society). In 2016, FHCI specialists treated 61 children with cancer. The disease is the second leading cause of death in children after accidents.

0 - 9 10 - 170

5

10

15

20

25

14

21

7

19

Male Female

Age Range


Pediatric Cancer Cases Diagnosis by GenderFor more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

The most commonly treated childhood cancers at FHCI in 2016 were blood and bone marrow, and brain cancers.

PAROTID GLAND

COLON

PANCREAS

HEART MEDIASTINUM PLEURA

BONES JOINTS & ARTICULA

R CARTILAGE

BONES JOINTS & OTHER UNSPECIFIED SITES

BLOOD & BONE M

ARROW

RETROPERITONEUM & PERITONEUM

CONNECTIVE SUBCUTANEOUS OTHER SOFT TISSUE OVARY

TESTIS

KIDNEYBRAIN

OTHER NERVOUS SYSTEM

THYROID GLAND

OTHER ENDOCRINE GLANDS

LYMPH NODES

ANY OTHERS0

4

8

12

2016 FHCI ANALYTICAL CHILDHOOD CANCERSSITE BY GENDER

MALE FEMALE


THORACIC ONCOLOGY

Mark A. Socinski, MDExecutive Medical DirectorMember, Thoracic Oncology ProgramFlorida Hospital Cancer Institute

Tarek Mekhail, MD, MSc, FRCSI, FRCSEdMedical Director, Thoracic Cancer ProgramAssociate Director of Clinical ResearchFlorida Hospital Cancer Institute

Joseph Boyer, MDSurgical Director, Thoracic Cancer ProgramDirector of Minimally Invasive and Robotic SurgeryFor more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

Florida Hospital Cancer Institute

The FHCI Thoracic Cancer Program has received national recognition for its multidisciplinary approach to the diagnosing and treating lung and esophageal cancers, mesothelioma, and other cancers involving organs within the chest wall. FHCI is one of the most active participants in lung and esophageal clinical trials in the nation.

Lung Cancer CasesAge at Diagnosis by Gender

In 2016, FHCI diagnosed lung cancer in 541 patients. In 68 percent of cases, the disease was detected in patients who were 60 to 79 years old.

20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

20

40

60

80

100

120

0 1 4

34

97 97

44

31 37

41

82

92

28

7

MALE FEMALE

Age Range


Lung Cancer CasesStage by Gender at Diagnosis


About 67 percent of men and 56 percent of women diagnosed at FHCI in 2016 were in stage III lung cancer.

1A 1B 2A 2B 3 3A 3B 40

20

40

60

80

100

120

140

38

2012 9

40

17

130

14

57

23

512

35

11

101

17

Male Female

Stage


Lung Cancer CasesFive-year SurvivalCases Diagnosed 2007-2013

Five-year survival for patients treated at FHCI significantly exceeded nine national cancer registries.


15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

55.00%

60.00%

27.11%

19.50%

FHCI Tri-County vs. nine Seer Registries (SEER = surveillance, epidemiology and end-results).Sources: FHCI Cancer Registry; SEER.gov CanQues

UROLOGIC ONCOLOGY

Vipul Patel MD, FACS


Medical Director, Global Robotics Institute, Celebration HealthMedical Director, Florida Hospital Cancer Institute Urologic Oncology ProgramProfessor of Urology, University of Central Florida

Inoel Rivera, MD, FACSUro-oncology Leadership Committee ChairUrologic Oncology ProgramFlorida Hospital Cancer Institute

Carlos Alemany, MD Hematology OncologyMedical Director, Genitourinary OncologyFlorida Hospital Cancer Institute

FHCI’s oncology team includes some of the country’s leading experts in urologic cancer. They use the latest in diagnostic technology and advanced surgical techniques, including MRI Fusion Biopsy, to customize patient treatment plans. FHCI pioneered robotic prostate surgery, which now accounts for more than 85 percent of all radical prostatectomy in the United States. The team is highly skilled in the use of the da Vinci® Surgical System – a less invasive, robotic-assisted procedure that has revolutionized the surgical process.

Genitourinary CancerCase Incidence

Prostate cancer remained the most treated type of cancer at FHCI, with 1245 new cases in 2016.

PROSTATE

TESTIS

BLADDER

KIDNEY/RENAL

OTHER

TOTALS

0 200 400 600 800 1000 1200 1400 1600 1800 2000

1245

37

239

227

22

1770

Number of Cases


Prostate Cancer CasesAge at Diagnosis


The most common age range at diagnosis for prostate cancer patients at FHCI was 60 to 69 years old.

30-39 40-49 50-59 60-69 70-79 80-89 90-990

100

200

300

400

500

600

700

147

320

589

248

346

Age Range


Prostate Cancer CasesStage at Diagnosis

Almost 40 percent of prostate cancer patients at FHCI in 2016 had stage II disease at diagnosis.

I II III IV Unknown0

100

200

300

400

500

600

94

490

310

82

269

Stage


Prostate CancerFive-year SurvivalCases Diagnosed 2007-2013For more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

The five-year survival rate for prostate cancer is one of the highest of all cancer types due to the success of early screening efforts and effective treatment options. In 2016, five-year survival for patients treated for prostate cancer at Florida Hospital was 100 percent.


30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

100.00%

110.00%

100.00% 99.20%

FHCI Tri-County vs nine SEER registries (SEER = surveillance, epidemiology and end-results)Sources: FHCI Cancer Registry; SEER.gov CanQues

Bladder Cancer CasesAge at Diagnosis

In 2016, FHCI specialists most often diagnosed bladder cancer in patients who were 70 to 79 years old.

30-39 40-49 50-59 60-69 70-79 80-89 90-990

10

20

30

40

50

60

70

80

1 3

23

45

72

37

41 0

4

1319

116

Male Female

Age Range

Source: FHCI Cancer RegistryBladder Cancer CasesStage at Diagnosis by Gender


Regardless of gender, patients were most often diagnosed with bladder cancer in stage 0 in 2016 at FHCI, but overall the disease was detected in men three times more frequently than in women.


Kidney Cancer CasesAge at Diagnosis by Gender

Based on the 227 new cases of kidney cancer diagnosed at FHCI in 2016, men were 34 percent more likely to develop the disease.

0-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90-990

5

10

15

20

25

30

35

40

45

1 0 0

7

15

2931

39

6

21 0 03

6

23

32

17

13

2

Male Female

Age Range


Kidney Cancer Cases


0A 0IS 1 2 3 4 Unknown0

10

20

30

40

50

60

70

80

90

77

3

45

22

9 1118

25

0

117

3 26

Male Female

Stage

Stage at Diagnosis by Gender

At FHCI in 2016, kidney cancer was most frequently diagnosed in both men and women at stage I.

0 1 2 3 4 Not Applicable Unknown0

10

20

30

40

50

60

1

39

5

17

12

1

55

0

40

3

8 7

1

38

Male Female

Stage


Penile Cancer CasesAge at Diagnosis

All cases of penile cancer diagnosed at FHCI occurred in men at the ages of 60 to 89.

50-59 60-69 70-79 80-89 90-990

0.5

1

1.5

2

2.5

0

2 2 2

0

Age Range


Penile Cancer CasesStage at Diagnosis


0 I II III IV UNK0

1

2

3

4

2

0 0 0 0

4

Stage


Testicular Cancer CasesAge at Diagnosis

The majority of the 37 patients diagnosed with testicular cancer at FHCI in 2016 were 20 to 39 years old at the time of diagnosis.

10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-890

2

4

6

8

10

12

3

11

10

8

2

1

0

2

Age Range


Testicular Cancer CasesStage at Diagnosis


About 35 percent of patients with testicular cancer were in stage I of the disease when diagnosed at FHCI.

I II III IV UNK N/A0

2

4

6

8

10

12

14

16

18

20

13

1

3

0

19

1

Stage


CANCER REGISTRY DATA

The cancer statistics included in this report are the result of work completed by the Florida Hospital Cancer Registry team, which collects a comprehensive data set for each newly diagnosed cancer patient. This data set includes information about patients’ presenting symptoms, diagnostic work-ups, clinical and pathologic stages, treatments, and lifelong follow-up activities. Data are collected according to Cancer Program Standards established by the American College of Surgeons Commission on Cancer, as well as the Florida Cancer Data Systems (FCDS), the state’s central registry. Data collected are disease-specific and standardized to ensure accurate information that can be compared with national and state outcomes for each type of cancer.

Cancer Cases Diagnosed in 2016National Comparison of the Select Cancer Sites to FHCI Tri-county AreaEstimated Cancer Cases from the American Cancer Society Cancer Facts & Figures 2016

Breast cancer was the most commonly diagnosed cancer nationally in 2016 and the second-most common in Florida. At FHCI, prostate cancer made up almost 19 percent of cases diagnosed and treated, whereas breast cancer accounted for about 13 percent.

FLORIDA HOSPITAL CANCER INSTITUTE FLORIDA NATIONAL

PRIMARY SITE CASES PERCENT CASES PERCENT CASES PERCENTFor more information visit our Website at FloridaHospitalCancer.com | 2016 Outcomes Data and Information

BREAST 1091 12.8% 16,770 13.8% 246,660 14.6%LUNG 761 8.9% 17,360 14.3% 224,390 13.3%PROSTATE 1595 18.7% 13,310 11.0% 180,890 10.7%COLORECTAL 652 7.7% 9,710 8.0% 134,490 8.0%BLADDER 317 3.7% 5,940 4.9% 76,960 4.6%NH LYMPHOMA 268 3.1% 5,370 4.4% 72,580 4.3%CORPUS UTERI 339 4.0% 3,940 3.2% 60,050 3.6%MELANOMA 213 2.5% 6,200 5.1% 76,380 4.5%LEUKEMIA 253 3.0% 3,930 3.2% 60,140 3.6%CERVIX 86 1.0% 1,050 0.9% 12,990 0.8%ALL OTHERS 2,934 34.5% 37,660 31.1% 539,680 32.0%

TOTAL CASES 8,509 100.0% 121,240 100.0% 1,685,210 100.0%

Tri-county area includes Orange, Osceola and Seminole counties.Sources: American Cancer Society, Cancer Facts & Figures 2016; FHCI Cancer Registry

FHCI Patients - Race by Ethnicity

ETHNICITY/RACENON-SPANISH

SPANISH, NOS; HISPANIC, NOS; LATINO, NOS

PUERTO RICAN UNKNOWN

SOUTH OR CENTRAL AMERICAN-NOT BRAZIL CUBAN MEXICAN

SPANISH SURNAME ONLY

DOMINICAN REPUBLIC

OTHER SPANISH

ALL OTHERS

TOTAL VALUES

# (%) # (%) # (%) # (%) # (%) # (%) # (%) # (%) # (%) # (%) # (%) # (% ) WHITE 5959 84.1 788 11.1 169 2.4 47 0.7 61 0.9 19 0.3 16 0.2 14 0.2 6 0.1 6 0.1 1 0 7086 83BLACK 912 98.3 9 1 2 0.2 3 0.3 0 0 1 0.1 0 0 0 0 0 0 1 0.1 0 0 928 10.9AMERICAN INDIAN ALEUT ESKIMO 13 92.9 0 0 0 0 0 0 1 7.1 0 0 0 0 0 0 0 0 0 0 0 0 14 0.2CHINESE 12 92.3 0 0 0 0 1 7.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0.2JAPANESE 3 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0FILIPINO 19 95 1 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0.2HAWAIIAN 3 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0KOREAN 5 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.1VIETNAMESE 13 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0.2THAI 3 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0ASIAN INDIAN OR PAKISTANI 48 98 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 49 0.6ASIAN INDIAN 17 94.4 0 0 0 0 0 0 1 5.6 0 0 0 0 0 0 0 0 0 0 0 0 18 0.2PAKISTANI 2 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0NEW GUINEAN 1 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0OTHER ASIAN 45 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0.5PACIFIC ISLANDER 4 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0OTHER 101 47.9 90 42.7 5 2.4 10 4.7 4 1.9 0 0 0 0 0 0 1 0.5 0 0 0 0 211 2.5UNKNOWN 88 73.3 11 9.2 2 1.7 15 12.5 3 2.5 0 0 0 0 0 0 1 0.8 0 0 0 0 120 1.4 OVERALL TOTALS 7248 84.9 900 10.5 178 2.1 76 0.9 70 0.8 20 0.2 16 0.2 14 0.2 8 0.1 7 0.1 1 0 8538 100

NOS stands for not otherwise specifiedSource: FHCI Cancer Registry

FHCI Primary Cancer Site Table

Male genitourinary cancer was the most commonly diagnosed cancer at FHCI in 2016, with prostate cancer


representing about 97 percent of those diagnoses.

PRIMARY SITE

TOTAL CLASS OF CASE GENDER AJCC STAGE

Analytic

alNon-

AnalyticalMale

Female 0 I II III IV

Unknown

Not Applicab

le

ALL SITES 8509 6780 1729452

0 398938

0170

2139

1120

5119

4 1589 1048

ORAL CAVITY 230 198 32 181 49 0 11 22 27 110 49 11

LIP 5 4 1 4 1 0 0 0 0 1 4 0

TONGUE 70 61 9 54 16 0 4 7 10 34 15 0

OROPHARYNX 16 11 5 14 2 0 0 0 0 9 7 0

HYPOPHARYNX 6 4 2 6 0 0 0 0 1 4 1 0

OTHER 133 118 15 103 30 0 7 15 16 62 22 11

DIGESTIVE SYSTEM 1642 1329 313 943 699 61 309 273 320 320 330 29

ESOPHAGUS 106 65 41 92 14 5 13 11 24 21 32 0

STOMACH 150 116 34 86 64 3 28 17 22 39 39 2

COLON 419 353 66 225 194 25 67 71 108 79 69 0

RECTUM 233 181 52 141 92 8 44 43 60 27 51 0 ANUS/ANAL CANAL 36 29 7 12 24 1 4 4 12 1 14 0

LIVER 186 150 36 117 69 0 52 23 29 24 37 21

PANCREAS 372 308 64 196 176 15 75 79 40 108 55 0

OTHER 140 127 13 74 66 4 26 25 25 21 33 6

RESPIRATORY SYSTEM 834 673 161 452 382 0 176 61 144 340 106 7

NASAL/SINUS 6 5 1 2 4 0 1 1 0 0 1 3

LARYNX 57 47 10 47 10 0 8 9 5 24 10 1

LUNG/BRONCHUS 761 614 147 398 363 0 166 51 139 312 90 3

OTHER 10 7 3 5 5 0 1 0 0 4 5 0

BLOOD & BONE MARROW 509 287 222 294 215 0 3 1 3 5 6 491

LEUKEMIA 253 161 92 152 101 0 3 1 3 5 6 235 MULTIPLE MYELOMA 137 85 52 74 63 0 0 0 0 0 0 137

OTHER 119 41 78 68 51 0 0 0 0 0 0 119

BONE 21 13 8 12 9 0 3 2 0 6 9 1


CONNECT/ SOFT TISSUE 29 22 7 12 17 0 3 3 5 5 13 0

SKIN 228 138 90 112 116 72 45 12 22 11 61 5

MELANOMA 213 125 88 103 110 72 44 12 19 9 57 0

OTHER 15 13 2 9 6 0 1 0 3 2 4 5

BREAST 1091 906 185 13 107810

4 380 291 105 47 164 0

FEMALE GENITAL 607 530 77 0 607 4 244 42 155 64 91 7

CERVIX UTERI 86 65 21 0 86 0 26 8 21 12 17 2 CORPUS UTERI 339 313 26 0 339 1 194 15 60 25 41 3

OVARY 136 114 22 0 136 0 21 13 61 20 21 0

VULVA 17 13 4 0 17 3 3 0 2 2 7 0

OTHER 29 25 4 0 29 0 0 6 11 5 5 2

MALE GENITAL 1642 1321 321164

2 0 2 183 581 327 105 441 3

PROSTATE 1595 1278 317159

5 0 0 171 580 323 105 416 0

TESTIS 39 35 4 39 0 0 12 1 4 0 21 1

OTHER 8 8 0 8 0 2 0 0 0 0 4 2

URINARY SYSTEM 620 499 121 415 205

137 151 42 40 50 195 5

BLADDER 317 242 75 234 8312

9 59 32 12 16 69 0

KIDNEY/RENAL 284 241 43 172 112 2 91 10 28 33 118 2

OTHER 19 16 3 9 10 6 1 0 0 1 8 3

BRAIN & CNS 327 246 81 139 188 0 0 0 0 0 1 326 BRAIN (BENIGN) 21 14 7 12 9 0 0 0 0 0 0 21 BRAIN (MALIGNANT) 122 108 14 66 56 0 0 0 0 0 0 122

OTHER 184 124 60 61 123 0 0 0 0 0 1 183

ENDOCRINE 306 280 26 80 226 0 138 14 18 18 58 60

THYROID 244 234 10 53 191 0 138 14 18 18 56 0

OTHER 62 46 16 27 35 0 0 0 0 0 2 60

LYMPHATIC SYSTEM 312 243 69 170 142 0 54 47 35 108 64 4 HODGKIN'S DISEASE 44 30 14 22 22 0 5 13 9 11 6 0 NON-HODGKIN'S 268 213 55 148 120 0 49 34 26 97 58 4

UNKNOWN PRIMARY 87 74 13 43 44 0 0 0 0 0 0 87


OTHER/ILL-DEFINED 24 21 3 12 12 0 2 0 4 5 1 12

Number of cases excluded: 29This report EXCLUDES CA in-situ cervix cases, squamous and basal cell skin cases, and intraepithelial neoplasia cases


Accredited by the American College of Surgeons Commission on Cancer

The American College of Surgeons Commission on Cancer (CoC) is a consortium of professional organizations dedicated to improving survival and quality of life of patients with cancer through standard setting prevention, research, education and the monitoring of comprehensive care. More than 50 leading cancer-care organizations, including the American Cancer Society, are partnered with the CoC on patient-centered initiatives. Across the United States, more than 1,500 cancer programs are CoC accredited, and more than 70 percent of cancer patients receive care at CoC accredited programs. Florida Hospital has been a continually accredited CoC program since 1989, demonstrating an important commitment to providing all patients with access to services from diagnosis through treatment, rehabilitation and survivorship care.

The National Cancer Database (NCDB) collects data from CoC-accredited cancer programs nationwide. The repository allows programs to compare patient characteristics, cancer types, treatment and outcomes with similar programs. The National Quality Forum (NQF) has identified and endorsed quality metrics reported as indicators of quality oncology care. Based on these indicators, the CoC measures cancer program performance with current CoC quality reporting tools – the Cancer Program Practice Profile Reports, or CP3R. By comparing adherence to and consideration of standards of care for specific tumor site populations at quarterly Comprehensive Cancer Committee meetings, quality improvement opportunities that aid in diminishing disparities in care are initiated. No patient identifiers are collected to generate the CP3R.

Data are collected currently for breast, colon, rectum, gastric, lung, cervix, ovary, endometrium, and bladder cases. To date, thresholds of compliance with providing or considering specific indicators are in place for breast, colon, rectum, gastric and lung primary tumor sites. The 2014 summary report released by the NCDB in April 2017 provides a performance report for Florida Hospital compared to National and Florida results, as well as those of cancer programs in the same CoC category, such as Florida Hospital – Academic Comprehensive Cancer Programs (ACAD). More information on the CP3R process and CoC accreditation is available at http://www.facs.org.


http://www.facs.org/

FHCI Cancer Program Practice Profile ReportsPerformance Rates

2014 Performance Rates - Percentages

Site Measure

CoC Benchma

rk Complian

ce Percentage Rate

National

Florida

Same Type CoC Program (Academic Compre- hensive Cancer Program)

FHCI Percenta

ge

Bladder

BL2RLN - At least 2 lymph nodes are removed in

patients under 80 undergoing partial or

radical cystectomy (Surveillance)

Not Applicabl

e93 92.2 95 100

Breast

BCS - Breast conservation surgery rate for women with AJCC clinical stage 0, I, or II breast cancer (Surveillance)

Not Applicabl

e64.6 62.9 63.2 61.6

Breast

nBx - Image or palpation-guided needle biopsy (core or FNA) of the primary site is performed to establish diagnosis of breast cancer (Quality Improvement)

80 92.6 89 9239 83.5

Breast

HT - Tamoxifen or third generation aromotase inhibitor is considered or administered within 1 year (365 days) of diagnosis for women with AJCC T1c or stage IB-III hormone receptor positive breast cancer (Accountability)

90 93.5 89.6 93.6 90.2

Breast

MASTRT - Radiation therapy is considered or administered following any mastectomy within 1 year (365 days) of

90 90.6 85.2 91.6 96.6


diagnosis of breast cancer for women with >= 4 positive regional lymph nodes (Accountability)

Breast

BCSRT - Radiation is administered within 1 year (365 days) of diagnosis for women under the age of 70 receiving breast conservation surgery for breast cancer (Accountability)

90 93 88.1 93 93.7

Breast

MAC - Combination chemotherapy is considered or administered within 4 months (120 days) of diagnosis for women under 70 with AJCC T1cN0, or stage IB - III hormone receptor negative breast cancer (Accountability)

Not Applicabl

e92.8 89.6 92.2 85.9

Colon

ACT - Adjuvant chemotherapy is considered or administered within 4 months (120 days) of diagnosis for patients under the age of 80 with AJCC stage III (lymph node positive) colon cancer (Accountability)

Not Applicabl

e89.9 81.7 89.4 75.6

Colon

12RLN - At least 12 regional lymph nodes are removed and pathologically examined for resected colon cancer (Quality Improvement)

85 91.4 90.1 93.2 93.5


Rectum

RECRTCT - Preoperative chemo and radiation are administered for clinical AJCC T3N0, T4N0, or Stage III; or Postoperative chemo and radiation are administered within 180 days of diagnosis for clinical AJCC T1-2N0 with pathologic AJCC T3N0, T4N0, or Stage III; or treatment is considered; for patients under the age of 80 receiving resection for rectal cancer (Quality Improvement)

85 89.2 87.4 89.2 94.1

Gastric

G15RLN - At least 15 regional lymph nodes are removed and pathologically examined for resected gastric cancer (Quality Improvement)

80% 58.1 52.5 65.8 75

Lung

10RLN - At least 10 regional lymph nodes are removed and pathologically examined for AJCC stage IA, IB, IIA, and IIB resected NSCLC (Surveillance)

Not Applicabl

e42.9 39.1 47.4 50

Lung

LNoSurg - Surgery is not the first course of treatment for cN2, M0 lung cases (Quality Improvement)

85% 92.9 91.6 92.3 97.5

Lung

LCT - Systemic chemotherapy is administered within 4 months to day preoperatively or day of surgery to 6 months postoperatively, or it is considered for surgically resected cases with pathologic lymph node-positive (pN1) and (pN2) NSCLC (Quality Improvement)

85% 93.2 92.8 92.5 95.8

Cervix

CERRT - Radiation therapy completed within 60 days of initiation of radiation among women

Not Applicabl

e80.2 87 79.5 61.5


diagnosed with any stage of cervical cancer (Surveillance)

Cervix

CERCT - Chemotherapy administered to cervical cancer patients who received radiation for stages IB2-IV cancer (Group 1) or with positive pelvic nodes, positive surgical margin, and/or positive parametrium (Group 2) (Surveillance)

Not Applicabl

e89 92.8 89.4 95.2

Cervix

CBRRT - Use of brachytherapy in patients treated with primary radiation with curative intent in any stage of cervical cancer (Surveillance)

Not Applicabl

e73.8 76.3 78.4 93.8

Endometrium

ENDCTRT - Chemotherapy and/or radiation administered to patients with Stage IIIC or IV Endometrial cancer (Surveillance)

Not Applicabl

e83.3 76.7 87.2 91.4

Endometrium

ENDLRC - Endoscopic, laparoscopic, or robotic performed for all Endometrial cancer (excluding sarcoma and lymphoma), for all stages except stage IV (Surveillance)

Not Applicabl

e75.2 80.4 73.4 71.6

Ovary

OVSAL - Salpingo-oophorectomy with omentectomy, debulking/cytoreductive surgery, or pelvic exenteration in Stages I-IIIC Ovarian cancer (Surveillance)

Not Applicabl

e71.9 72.7 71.9 70

as of 10.20.2017|Source: National Cancer Data Base

ONCOLOGY CLINICAL PERFORMANCE IMPROVEMENT

Rose Fan Ting Yue, BSN, RN, LHCRM, CPHQ


Project Manager Clinical Performance Improvement Florida Hospital Cancer Institute

Meiling Wu, MSN, RN, BSN, MSNProject Manager Clinical Performance ImprovementFlorida Hospital Cancer Institute

Westley ShengClinical Quality Improvement CoordinatorClinical Performance ImprovementFlorida Hospital Cancer InstituteAt FHCI, quality care refers to the entirety of a patient’s experience. The core mission of our Quality Improvement Initiative is to continuously improve research, training and patient care. We achieve this with a comprehensive review and evaluation process. Members of our Quality Improvement team use data to analyze, assess and improve the structure, function and outcomes of the entire system. The Quality Improvement team, along with tumor-site leadership, use the data to set goals, measure performance, and analyze patient outcomes to improve care.

Quality Oncology Practice Initiative Accreditation Standards Overall Quality Measures ScoreData collected 2013-2016

For the fifth consecutive year, FHCI Medical Oncology reached national accreditation standards adopted from American Society of Clinical Oncology-Quality Oncology Practice Initiative. FHCI also achieved program certification for the second time.


Overall Quality Score Pain addressed Documented plan for antineoplastic treatment

Patient emotional well-being assessed

90.50%

79.49%

100.00% 100.00%

90.55%87.97%

100.00% 100.00%95% 93%

98% 98%

89.00%86.42%

98.65%

90.12%

75%78%

81%77%

QOPI Accreditation Standards

FHCI 2016 FHCI 2015 FHCI 2014 FHCI 2013 Benchmark

Source: FHCI Quality Improvement

Quality Oncology Practice InitiativeColorectal Cancer Measures ScoreCases diagnosed 2015-2016


Colore

ctal 6

6: CEA w

ithin fo

ur mon

ths o

f cura

tive rese

ction fo

r color

ectal c

ance

r

Colore

ctal 6

8: Adjuvant a

ntineopla

stic t

reatm

ent rece

ived with

in four m

onths o

f diagnosis

by patients with

AJC

C stag

e III co

lon cance

r

Colore

ctal 7

2: Adjuvant c

hemothera

py re

ceived w

ithin nine m

onths o

f diagn

osis by p

atients with

AJC

C stage

II or

III re

ctal c

ancer

Colore

ctal 7

3: Colonosco

py before or w

ithin si

x month

s of c

urative co

lorecta

l res

ection or c

ompletion of prim

ary adjuv

ant chemoth

erapy

92%

100% 100%

86%87%90%

100%97%

92%95%

97%

88%

Colorectal Cancer Treatment Compared with QOPI Standards

FHCI 2016 FHCI 2015 Benchmark


Focus Study

The Quality Improvement team has continued to conduct all quality studies according to the standards of the American College of Surgeons’ (ACoS) Commission on Cancer (CoC) program, American Society Clinical Oncology’s (ASCO) Quality Oncology Practice Initiative (QOPI), National Accreditation Program for Breast Centers (NAPBC) and American College of Radiology (ACR). In addition, the Quality Improvement team launched focus studies in 2011 to improve patient care, comparing its performance with national standards and evidence-based practice guidelines. Cancer sites addressed by the focus studies included pancreas and bladder. Annual monitoring provides a reference for progress.

Pancreatic Cancer Focus Study Surgical TreatmentFHCI Compared to National StandardsCases diagnosed in 2012-2014


In 2014, FHCI pancreatic surgical treatments outperformed the national benchmark in 30-day readmission percentages and other key measures.

Pancreatic Surgical MeasuresFHCI 2014 FHCI 2013 FHCI 2012

National Benchmark

Average OR time (mins) 497 500 254 ≤600 mins

Estimate Blood loss (median, mL)300 500 450 ≤1000mL

Transfusion (%, pt) 24% 19% 36% ≤45% Lymph node resected and examined

(Mean, LN) 15 14 14 10 ≥10 Lymph node resected and examined

(%, pt) 74% 81% 75% 50%

Margins Microscopically involve (%, pt)15% 22% 10% 20%

Stay (median, days) 9 14 18 ≤(9-21)30 Days re-admission (%, pt) 17% 31% 23% ≤(23%-33%)

30 days mortality (%, pt) 2 0% 8% ≤2%1-year survival rate (%, pt) 35% 36% 30% 28%


Bladder Cancer Focus StudySurgical TreatmentFHCI Compared to National StandardsCases diagnosed in 2013 - 2014

FHCI performed well in many key measures when compared with 2014 national benchmark standards, including the range of length of stay for FHCI patients undergoing radical cystectomy, which was significantly shorter than the benchmark.

Bladder Measures FHCI 2014 FHCI 2013National

Benchmark

Range OR Time (mins) 100-513 70-502 ≤110-598 mins

Median OR Time (mins) 313 303 ≤292 mins

Range LOS (days) 1 to 20 3 to 19 ≤4-48 days

Intraoperative Complication 39% 39% ≤39%30 Days re-admissions 11% 31% ≤12%



Documents

· Web viewFlorida Hospital Cancer Institute Melvin Field, MD Neurosurgical Director – Gamma Knife Center and Neuroscience Institute The FHCI Brain and Spine Program specializes