In this study, researchers from Scotland prospectively collected population based data on 3293 cancers diagnosed over a 2 year period, with a minimum 1-year follow up.
The project examined whether hospital size was related to outcome in gastric and esophageal cancers.
|There was no difference in postoperative mortality for either gastric or esophageal cancer by hospital size.|
The team divided the 53 participating hospitals by caseload.
The researchers found that small hospitals had significantly less delay in diagnosis than larger institutions. However, this did not significantly improve subsequent survival.
In addition, the team found no statistically significant difference in postoperative mortality for either gastric or esophageal cancer by hospital size.
Overall survival was 32% at 1 year (54% for surgical patients) and 17% at 2 years (33% for surgical patients).
They determined that factors adversely affecting survival in surgical patients were American Society of Anesthesiologists grade 4 or 5, and margin involvement by the tumor.
In contrast, they found that non-smokers, patients with junctional cancers, and those with a history of Helicobacter pylori infection had better survival.
Once data were analyzed, the team found that there was no difference in survival according to either the size of the hospital of presentation, or hospital of surgery.
Dr Thompson’s team concluded, “In combination with data emerging from elsewhere, the guidance on the organization of esophago-gastric cancer services in the UK should be reviewed”.