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Review
. 2024 Oct;21(4):411-418.
doi: 10.1007/s10388-024-01080-w. Epub 2024 Aug 19.

Outcome research on esophagectomy analyzed using nationwide databases in Japan: evidences generated from real-world data

Yoshihiro Kakeji  1 , Hiroyuki Yamamoto  2 , Masayuki Watanabe  3 , Koji Kono  4 , Hideki Ueno  5 , Yuichiro Doki  6 , Yuko Kitagawa  7 , Hiroya Takeuchi  8 , Ken Shirabe  9 , Yasuyuki Seto  10
Affiliations
Review

Outcome research on esophagectomy analyzed using nationwide databases in Japan: evidences generated from real-world data

Yoshihiro Kakeji et al. Esophagus. 2024 Oct.

Abstract

Esophagectomy for esophageal cancer is a highly invasive gastrointestinal surgical procedure. The National Clinical Database (NCD) of Japan, initiated in 2011, has compiled real-world data on esophagectomy, one of nine major gastroenterological surgeries. This review examines outcomes after esophagectomy analyzed using the Japanese big databases. Certification systems by the Japanese Society of Gastroenterological Surgery (JSGS) and the Japan Esophageal Society (JES) have shown that institutional certification has a greater impact on short-term surgical outcomes than surgeon certification. Minimally invasive esophagectomy has emerged as a viable alternative to open esophagectomy, although careful patient selection is crucial, especially for elderly patients with advanced tumors. The NCD has significantly contributed to the assessment and enhancement of surgical quality and short-term outcomes, while studies based on Comprehensive Registry of Esophageal Cancer in Japan (CRECJ) have provided data on patient characteristics, treatments, and long-term outcomes. The JES has conducted various questionnaire-based retrospective clinical reviews in collaboration with authorized institutions certified by JES. The Diagnosis Procedure Combination (DPC) database provides administrative claims data including itemized prices for surgical, pharmaceutical, laboratory, and other inpatient services. Analyzing these nationwide databases can offer precise insights into surgical quality for esophageal cancer, potentially leading to improved treatment outcomes.

Keywords: DPC; Esophagectomy; Morbidity; Mortality; NCD.

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Conflict of interest statement

Author Kitagawa Y received research grants from ASAHI KASEI PHARMA CORPORATION, ONO PHARMACEUTICAL CO., LTD., Otsuka Pharmaceutical Factory Inc., Nippon Covidien Inc., TAIHO PHARMACEUTICAL CO., LTD, Chugai Pharmaceutical Co., Ltd., KAKEN PHARMACEUTICAL CO., LTD., EA Pharma Co., Ltd., Yakult Honsha Co. Ltd., Otsuka Pharmaceutical Co., Ltd., TSUMURA & CO., Sumitomo Pharma Co., Ltd., Eisai Co., Ltd., Kyowa Kirin Co., Ltd., Takeda Pharmaceutical Company Limited, TEIJIN PHARMA LIMITED, Cardinal Health and Kowa Company, Ltd. to his institution, and educational presentation or writing fees personally from ASAHI KASEI PHARMA CORPORATION, AstraZeneca K.K., Ethicon Inc., ONO PHARMACEUTICAL CO., LTD., Otsuka Pharmaceutical Factory Inc., Olympus Corporation, Cardinal Health K.K., Shionogi & Co., Ltd., TAIHO PHARMACEUTICAL CO., LTD, Chugai Pharmaceutical Co., Ltd., Bristol-Myers Squibb K.K., MSD K.K., Smith & Nephew KK, KAKEN PHARMACEUTICAL CO., LTD., ASKA Pharmaceutical Co., Ltd., MIYARISAN PHARMACEUTICAL CO. LTD., Toray Industries, Inc., DAIICHI SANKYO COMPANY, LIM ITED, Chugai Foundation for Innovative Drug Discovery Science, Nippon Kayaku Co., Ltd., EA Pharma Co. LTD., Intuitive Surgical G.K., Takeda Pharmaceutical Company Limited, SYSMEX CORPORATION, and TSUMURA & CO. He also received financial or non-financial supports as Joint Research Laboratory for Development and Education of Innovative Medical Technology from SYSMEX CORPORATION and Medicaroid Corporation. He is also an Editor in chief of Annals of Gastroenterological Surgery published by the Japanese Society of Gastroenterological Surgery. The author Yamamoto H is affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo, which is a social collaboration department supported by the National Clinical Database, Intuitive Surgical Sarl, Johnson & Johnson K.K., and Nipro Corporation. None of the other authors has any commercial sponsorship to disclose regarding this research. The authors Kakeji Y, Watanabe M, Kono K, Ueno H, Doki Y, Takeuchi H, Shirabe K, and Seto Y declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Facility’s severity-adjusted clinical performance (benchmark) compared with national data, illustrating short-term outcomes for a hypothetical facility. Upper tables: the NCD provide data on each facility’s severity-adjusted clinical performance (benchmark), which can be compared with national data (expected rate). Lower graphs: changes in outcomes pre- and post-implementation of operational procedures or perioperative management can be assessed through observed/expected (O/E) ratio comparisons
See this image and copyright information in PMC

References

    1. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer. Available from: https://gco.iarc.who.int/today, Accessed 14 Mar 2024.
    1. Gotoh M, Miyata H, Hashimoto H, et al. National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today. 2016;46:38–47. 10.1007/s00595-015-1146-y - DOI - PMC - PubMed
    1. Seto Y, Kakeji Y, Miyata H, et al. National Clinical Database (NCD) in Japan for gastroenterological surgery: Brief introduction. Ann Gastroenterol Surg. 2017;1:80–1. 10.1002/ags3.12026 - DOI - PMC - PubMed
    1. Kakeji Y, Yamamoto H, Ueno H, et al. Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database. Surg Today. 2021;51:187–93. 10.1007/s00595-020-02075-7 - DOI - PubMed
    1. Tomotaki A, Kumamaru H, Hashimoto H, et al. Evaluating the quality of data from the Japanese National Clinical Database 2011 via a comparison with regional government report data and medical charts. Surg Today. 2019;49:65–71. 10.1007/s00595-018-1700-5 - DOI - PubMed