In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 4_suppl ( 2012-02-01), p. 98-98
Kurzfassung:
98 Background: In Europe, several countries have implemented national audit programs to reduce variation in outcomes and improve care for esophageal and gastric cancer. These audits provide insight in national variations, but currently no international comparisons can be made. Purposes of the current study were to compare patterns of care and outcomes in several European countries, and to evaluate the effect of hospital volume on outcomes for esophagectomy and gastrectomy. Methods: Data were obtained from national cancer registries or audits in the Netherlands, Sweden, Denmark, and the United Kingdom. Differences in postoperative 30-day mortality and 2-year survival were adjusted for available case-mix variables and separately analyzed for esophagectomy and gastrectomy, using generalized estimated equations and Cox regression. In the current study, high-volume hospitals were defined as hospitals with an annual volume of 〉 20. Results: From 2004-2009, 10,854 esophagectomies and 9,010 gastrectomies were performed in the participating countries. Availability of case-mix variables varied between countries, and a limited number of variables could be used in the international comparison. On univariate analysis, 30-day mortality and 2 year survival differed significantly between participating countries, but on multivariate analysis, no significant differences were found. The percentage of resections performed in high-volume hospitals varied considerably between countries (esophagectomy: 20% to 94%, gastrectomy: 0% to 59%). Increasing annual hospital volume was associated with lower 30-day mortality after esophagectomy (P 〈 0.001) and gastrectomy (P = 0.025), and with improved 2-year survival after esophagectomy (P = 0.004), but not after gastrectomy. Conclusions: This study provides an initial step towards a European Upper GI Cancer Audit. However, with the available data only limited case-mix adjustments could be made. Future steps would include synchronization of registered variables and the use of uniform variable definitions. Increasing annual hospital volume is associated with improved short-term outcomes of upper GI cancer surgery.
Materialart:
Online-Ressource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.4_suppl.98
Sprache:
Englisch
Verlag:
American Society of Clinical Oncology (ASCO)
Publikationsdatum:
2012
ZDB Id:
2005181-5
