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News

Epidemiology of surgically treated gastric cancer

Rates of resection for gastric cancer have declined slightly during the past 13 years, find doctors in Michigan, USA.

News image

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The incidence of gastric cancer has decreased the United States. However, there are few population-based studies assessing the magnitude of these changes.

In this study, doctors identified temporal trends in the use of gastric resection for the treatment of gastric cancer.

The team's findings are published in the November issue of the Journal of Gastrointestinal Surgery.

Data was taken from the Nationwide Inpatient Sample, 1988 to 2000. This is a 20% stratified random sample which is representative of all US hospitals.

The doctors included all patients with a primary diagnosis code for gastric cancer and a procedure code for gastric resection.
Gastric resection has declined by 20%.
Journal of Gastrointestinal Surgery

The team recorded overall incidence of resection for gastric cancer, in-hospital mortality rate, and length of stay.

They presented the rates of surgery as the number of cases per 100,000 hospital discharges.

Hospital volume was grouped as low (1 to 4 cases per year), medium (5 to 8 cases per year), and high (9 or more cases per year).

The doctors found that gastric resection declined by 20% during the study period. However, in-hospital mortality has remained unchanged at 7%.

They determined that there was significant variation in mortality between hospitals. Low volume centers had a 9% mortality rate, while high volume centers had a 6% mortality rate.

The team also found that over the 13-year period studied, patients' length of stay decreased from 15 days in 1988 to 11 days in 2000.

Dr Reid Wainess's team concluded, "Rates of gastric resection for cancer have shown a modest decline over the past 13 years in the United States".

"Although the length of stay for these patients has decreased, no significant changes to in-hospital mortality have occurred".

"Given the declining rates of gastric cancer surgery, and the superior outcomes at high-volume centers, regionalization of care may improve mortality rates for this high-risk surgical procedure".

J Gastrointest Surg 2003; 7(7): 879-83
06 November 2003

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