Volume-outcome revisited: The effect of hospital and surgeon volumes on multiple outcome measures in oesophago-gastric cancer surgery

305 Background: There is a known volume-outcome association for complex surgial procedures such as oncologic gastric resections. The aim of this study was to describe the process of centralization for gastric cancer surgery in the Netherlands in relation to other types of upper gastrointestinal (GI) cancer resections and to investigate whether the quality of gastric cancer surgery is affected by the overall experience with those related complex surgical procedures. Methods: Data on all patients (n = 4251) who underwent surgical treatment for non metastatic invasive gastric cancer between 2005-2013 were obtained from the Netherlands Cancer Registry. Annual hospital volume categories were based on the overall volume of gastrectomies, esophagectomies and pancreatectomies together (composite hospital volume). Volume-outcome analyses were performed for lymph node yield, 30-day mortality, and overall survival. Results: The percentage of gastric cancer patients who underwent a resection in a hospital with a volume of at least 20 gastrectomies per year increased. At the same time, the percentage of gastric cancer patients who underwent surgery in hospitals with an annual composite hospital volume of at least 20 upper GI cancer resections, such as esophageal and pancreatic cancer resections, increased. A higher composite hospital volume was associated with a higher lymph node yield, a lower 30-day mortality, and an increased overall survival. Conclusions: In the Netherlands, an increasing proportion of gastric cancer resections is performed in hospitals that are high volume centers for esophagectomies and pancreatectomies for cancer. Experience with these complex surgical procedures has a favorable effect on the outcomes of gastric cancer surgery.

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Possible impact of COVID-19 on gastric cancer surgery in Italy

Minerva Chirurgica ◽

10.23736/s0026-4733.20.08381-9 ◽

2020 ◽

Vol 75 (5) ◽

Author(s):

Fausto Rosa ◽

Sergio Alfieri

Keyword(s):

Gastric Cancer ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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Identification of Significant Genes with Peritoneal Metastasis After Gastric Cancer Surgery via Bioinformatical Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3471980 ◽

2019 ◽

Author(s):

Shengjie Lin ◽

Tao Jiang ◽

Guizhen Wen ◽

Wenyu Gao ◽

Xuan Gao ◽

...

Keyword(s):

Gastric Cancer ◽

Peritoneal Metastasis ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Bioinformatical Analysis

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Nutrition update in gastric cancer surgery

Annals of Gastroenterological Surgery ◽

10.1002/ags3.12351 ◽

2020 ◽

Vol 4 (4) ◽

pp. 360-368 ◽

Cited By ~ 1

Author(s):

Takeshi Kubota ◽

Katsutoshi Shoda ◽

Hirotaka Konishi ◽

Kazuma Okamoto ◽

Eigo Otsuji

Keyword(s):

Gastric Cancer ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-033267 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033267

Author(s):

Dengfeng Wang ◽

Yang Yu ◽

Pengxian Tao ◽

Dan Wang ◽

Yajing Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Venous Thromboembolism ◽

Evaluation Method ◽

Clinical Decision Making ◽

Meta Analysis ◽

Cancer Surgery ◽

Published Data ◽

Gastric Cancer Surgery ◽

Positive Prevention

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562

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Prognosis after surgery for gastric adenocarcinoma in the Swedish Gastric Cancer Surgery Study (SWEGASS)

Acta Oncologica ◽

10.1080/0284186x.2021.1874619 ◽

2021 ◽

pp. 1-8

Author(s):

Johannes Asplund ◽

Eivind Gottlieb-Vedi ◽

Wilhelm Leijonmarck ◽

Fredrik Mattsson ◽

Jesper Lagergren

Keyword(s):

Gastric Cancer ◽

Gastric Adenocarcinoma ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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A Prospective Multicenter Observational Study of Venous Thromboembolism after Gastric Cancer Surgery (SHISA-1601)

European Surgical Research ◽

10.1159/000514309 ◽

2021 ◽

pp. 1-10

Author(s):

Sachiko Kaida ◽

Toru Miyake ◽

Satoshi Murata ◽

Tsuyoshi Yamaguchi ◽

Takeshi Tatsuta ◽

...

Keyword(s):

Gastric Cancer ◽

Venous Thromboembolism ◽

Blood Transfusion ◽

Observational Study ◽

Characteristic Curve ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Multicenter Observational Study ◽

Prospective Multicenter Observational Study ◽

D Dimer

Introduction: This study aimed to clarify the frequency and risk factors of intercurrent venous thromboembolism (VTE) in patients undergoing major curative gastric cancer surgery. Methods: This prospective, multicenter, observational study included patients with gastric cancer who underwent radical gastrectomy at 5 hospitals between June 2016 and May 2018. Patients who were preoperatively administered anticoagulants were excluded. Results: A total of 126 patients were eligible to participate. VTE occurred within 9 days postoperatively in 5 cases (4.0%; 2 symptomatic and 3 asymptomatic). Postoperative day (POD) 1 plasma D-dimer and soluble fibrin (SF) levels were significantly higher in the VTE group than in the non-VTE group. Receiver-operating characteristic curve (ROC) analysis indicated a statistically significant ability of POD 1 D-dimer and SF levels to predict postoperative VTE development after gastrectomy; this finding was reflected by an area under the curve (AUC) of 0.97 (95% CI 0.92–1.0) and 0.87 (95% CI 0.74–1.0), respectively. Cutoff values of D-dimer (24.6 µg/mL) and SF (64.1 µg/mL) were determined. Intraoperative blood transfusion (odds ratio [OR] 7.86), POD 1 D-dimer ≥24.6 µg/mL (OR 17.35), and POD 1 SF ≥64.1 µg/mL (OR 19.5) were independent predictive factors for postoperative VTE (p < 0.05). Conclusion: VTE occurred in 4.0% patients (1.6% symptomatic and 2.4% asymptomatic) after gastric cancer surgery; however, with an early diagnosis and anticoagulant therapy, no patients experienced progression. Careful observation of patients with a high risk for VTE, including intraoperative blood transfusion and high POD 1 D-dimer or SF levels, would contribute to the early detection of VTE.

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