{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:45:17Z","timestamp":1789011917760,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2011,8,26]],"date-time":"2011-08-26T00:00:00Z","timestamp":1314316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>The impact of physicians' disease\u2010specific expertise on patient outcome is unknown. Although previous studies suggest a survival advantage for cancer patients cared for at high\u2010volume centers, these observations may simply reflect referral bias or better access to advanced technologies, clinical trials, and multidisciplinary support at large centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We evaluated time to first treatment (TTFT) and overall survival (OS) of patients with newly diagnosed chronic lymphocytic leukemia\/small lymphocytic lymphoma (CLL) at a single academic center based on whether they were cared for by a hematologist\/oncologist who subspecializes in CLL (CLL hematologist) or a hematologist\/oncologist with expertise in other areas (non\u2010CLL hematologist).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Among 1309 newly diagnosed patients with CLL cared for between 1999 and 2009, 773(59%) were cared for by CLL hematologists and 536 were cared for by non\u2010CLL hematologists. Among early\u2010stage patients (Rai 0\u2010I), median TTFT (9.2 vs 6.1 years; <jats:italic>P<\/jats:italic> &lt; .001) and OS (10.5 years vs 8.8 years; <jats:italic>P<\/jats:italic> &lt; .001) were longer for patients cared for by CLL hematologists. For all patients, OS was superior for patients cared for by CLL hematologists (10.5 years vs 8.4 years; <jats:italic>P<\/jats:italic> = .001). Physician's disease\u2010specific expertise remained an independent predictor of OS after adjusting for age, sex, stage, and lymphocyte count at diagnosis. Patients seen by a CLL hematologist were also more likely to participate in clinical trials (48% vs 16%; <jats:italic>P<\/jats:italic> &lt; .001).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Physician disease\u2010specific expertise appears to influence outcome in patients with CLL. To the greatest extent possible, patients should be cared for by a hematologist\/oncologist expert in the care of their specific malignancy. When not possible, practice guidelines developed by disease\u2010specific experts should be followed. Cancer 2012. \u00a9 2011 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.26474","type":"journal-article","created":{"date-parts":[[2011,8,31]],"date-time":"2011-08-31T23:41:10Z","timestamp":1314834070000},"page":"1827-1837","source":"Crossref","is-referenced-by-count":39,"title":["Hematologist\/oncologist disease\u2010specific expertise and survival: Lessons from chronic lymphocytic leukemia (CLL)\/small lymphocytic lymphoma (SLL)"],"prefix":"10.1002","volume":"118","author":[{"given":"Tait D.","family":"Shanafelt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil E.","family":"Kay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari G.","family":"Rabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Inwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive S.","family":"Zent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose F.","family":"Leis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Schwager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie A.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A.","family":"Bowen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Witzig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Slager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Call","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,8,26]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.11.2327"},{"key":"e_1_2_7_3_2","first-page":"471","article-title":"Hodgkin's disease in the United States: a comparison of patient characteristics and survival in the Centralized Cancer Patient Data System and the Surveillance, Epidemiology, and End Results Program","volume":"78","author":"Davis S","year":"1987","journal-title":"J Natl Cancer Inst."},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.2.368"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)91082-W"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/91.10.839"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1991.9.5.818"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V79.10.2771.bloodjournal79102771"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01806003"},{"key":"e_1_2_7_10_2","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1056\/NEJMsa0906323","article-title":"Physician cost profiling\u2014reliability and risk of misclassification","volume":"362","author":"Adams JL","journal-title":"N Engl J Med."},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-093906"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.12.3835"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-08-207126"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2007.1.324"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041720"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.9098"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.8389"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.25.3187"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4757"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.12.051"},{"key":"e_1_2_7_21_2","first-page":"112","article-title":"Immunochemotherapy with fludarabine (F), cyclophosphamide (C), and rituximab (R) (FCR) versus fludarabine and cyclophosphamide (FC) improves response rates and progression\u2010free survival (PFS) of previously untreated patients (pts) with advanced chronic lymphocytic leukemia (CLL)","author":"Hallek M","year":"2008","journal-title":"Blood."},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-07-033274"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61381-5"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07086.x"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2007.1.332"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.0038"},{"key":"e_1_2_7_27_2","doi-asserted-by":"crossref","first-page":"4990","DOI":"10.1182\/blood.V87.12.4990.bloodjournal87124990","article-title":"National Cancer Institute\u2010Sponsored Working Group Guidelines fo Chronic Lymphocytic Leukemia: revised guidelines for diagnosis and treatment","volume":"87","author":"Cheson BD","year":"1996","journal-title":"Blood."},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-09-176149"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24004"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25292"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06801.x"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701724785"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701724801"},{"key":"e_1_2_7_34_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2008.07070.x"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2007.06965.x"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2003.04265.x"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.2001.03149.x"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.9492"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.4508"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012143432402"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91681-5"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V98.8.2319"},{"key":"e_1_2_7_43_2","first-page":"114","article-title":"Long\u2010term survival analysis of the North American Intergroup Study C9011 comparing fludarabine (F) and chlorambucil (C) in previously untreated patients with chronic lymphocytic leukemia (CLL)","author":"Rai K","year":"2009","journal-title":"Blood."},{"key":"e_1_2_7_44_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2010-0090"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.26474","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.26474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T21:22:48Z","timestamp":1760304168000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.26474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,26]]},"references-count":43,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["10.1002\/cncr.26474"],"URL":"https:\/\/doi.org\/10.1002\/cncr.26474","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,26]]}}}