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. 2007 Apr;11(4):410-9; discussion 419-20.
doi: 10.1007/s11605-006-0040-8. Epub 2007 Mar 14.

Treatment of gastric adenocarcinoma may differ among hospital types in the United States, a report from theNational Cancer Data Base

Kaye M Reid-Lombardo  1 , Greer Gay, Lina Patel-Parekh, Jaffer A Ajani, John H Donohue; Gastric Patient Care Evaluation Group from the Commission on Cancer
Affiliations

Treatment of gastric adenocarcinoma may differ among hospital types in the United States, a report from theNational Cancer Data Base

Kaye M Reid-Lombardo et al. J Gastrointest Surg. 2007 Apr.

Abstract

The concept that complex surgical procedures should be performed at high-volume centers to improve surgical morbidity and mortality is becoming widely accepted. We wanted to determine if there were differences in the treatment of patients with gastric cancer between community cancer centers and teaching hospitals in the United States. Data from the 2001 Gastric Cancer Patient Care Evaluation Study of the National Cancer Data Base comprising 6,047 patients with gastric adenocarcinoma treated at 691 hospitals were assessed. The mean number of patients treated was larger at teaching hospitals (14/year) when compared to community centers (5-9/year) (p<0.05). The utilization of laparoscopy and endoscopic ultrasonography were significantly more common at teaching centers (p<0.01). Pathologic assessment of greater than 15 nodes was documented in 31% of specimen at community hospitals and 38% at teaching hospitals (p<0.01). Adjusted for cancer stage, chemotherapy and radiation therapy were utilized with equal frequency at all types of treatment centers. The 30-day postoperative mortality was lowest at teaching hospitals (5.5%) and highest at community hospitals (9.9%) (p<0.01). These data support previous publications demonstrating that patients with diseases requiring specialized treatment have lower operative mortality when treated at high-volume centers.

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Figures

Figure 1
Figure 1
Location of cancer at presentation by cancer program types: A Community Hospital Cancer Program (CHCP), B Community Hospital Comprehensive Cancer Program (COMP), and C Teaching Hospital Cancer Program (THCP). Location of lesions: cardia, funds, body, antrum, pyloric, lesser curve, and greater curve by percent and others indicated by asterisk (C168, overlapping lesions and C169, stomach, NOS).
Figure 2
Figure 2
Percent of lymph nodes sampled at each hospital. CHCP = Community Cancer Center Program, COMP = Community Hospital Comprehensive Cancer Program, THCP = Teaching Hospital Cancer Program. p < 0.05 (asterisk). Error bars: 95% CI.
See this image and copyright information in PMC

References

    1. None
    2. American Cancer Society. Cancer Facts and Figures 2006. Atlanta, GA: American Cancer Society, 2006.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1002/(SICI)1097-0142(20000215)88:4<921::AID-CNCR24>3.0.CO;2-S', 'is_inner': False, 'url': 'https://doi.org/10.1002/(sici)1097-0142(20000215)88:4<921::aid-cncr24>3.0.co;2-s'}, {'type': 'PubMed', 'value': '10679663', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10679663/'}]}
    2. Hundahl SA, Phillips JL, Menck HR. The National Cancer Data Base report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: Fifth edition American Joint Committee on Cancer staging, proximal disease, and the “different disease” hypothesis. Cancer 2000;88:921–932. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1093/jjco/hyi030', 'is_inner': False, 'url': 'https://doi.org/10.1093/jjco/hyi030'}, {'type': 'PubMed', 'value': '15709097', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15709097/'}]}
    2. Imamura Y, Yoshimi I. Comparison of cancer mortality (stomach cancer) in five countries: France, Italy, Japan, UK and USA from the WHO mortality database (1960–2000). Jpn J Clin Oncol 2005;35:103–105. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '10804656', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10804656/'}]}
    2. Testa T, Nahum MA, Spinelli E, Carbone E, Flocchini GP, Motta G. The “Will Rogers effect” on stage grading. Ann Ital Chir 1999;70:829–830. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1067/msy.1999.98735', 'is_inner': False, 'url': 'https://doi.org/10.1067/msy.1999.98735'}, {'type': 'PubMed', 'value': '10455881', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/10455881/'}]}
    2. Birkmeyer JD, Warshaw Al, Finlayson SRG, Grove MR, Tosteson ANA. Relationship between hospital volume and late survival after pancreaticoduodectomy. Surgery 1999;126:78–83. - PubMed