title: The Quid Pro Quo of pediatric versus adult services for older adolescent cancer patients.
abstract: OBJECTIVE
  Data from the State of Georgia suggest that pediatric cancers have better survival outcomes when treated at pediatric cancer centers that are members of the nation's Children's Oncology Group (COG).
  
  
  METHODS
  To determine if the more adult types of cancer that occur in adolescents are better treated at centers with adult oncology expertise, the reported data were re-analyzed according to a scale that assessed whether the type of cancer was more likely to have been treated by oncologists with pediatric versus adult cancer experience.
  
  
  RESULTS
  The results showed that survival hazard index was linearly correlated in 15- to 19-year-olds with the pediatric versus adult cancer type index (P < 0.0001). All of the five most pediatric type of cancers had a better survival at COG institutions and all of the three tumors with a better survival at non-COG institutions had the highest adult type scores.
  
  
  CONCLUSIONS
  These results demonstrate that adolescent patients with pediatric types of cancer fare better when their care is conducted or supervised by oncologists who specialize in the care of their type of cancer. The Georgia data are among the first to indicate that the more adult type of cancers are better treated on an adult treatment regimen and/or under the supervision or in conjunction with adult-treating oncologists.
authors.affiliation: Cancer Treatment Center, St. Charles Medical Center, Bend, Oregon, USA. ableyer@cascadehealthcare.org
authors.forename: Archie
authors.initials: A
authors.lastname: Bleyer
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services; D017677:Age Distribution; D002173:Cancer Care Facilities; D003657:Decision Making; D005845:Georgia; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D055815:Young Adult