Effect of hospital characteristics on outcome of patients with gastric cancer: A population based study in North-East Netherlands

Siemerink, E.J.M.; Schaapveld, M.; Plukker, J.T.M.; Mulder, N.H.; Hospers, G.A.P.

doi:10.1016/j.ejso.2010.03.011

« Previous Next »European Journal of Surgical Oncology
Volume 36, Issue 5 , Pages 449-455, May 2010

Effect of hospital characteristics on outcome of patients with gastric cancer: A population based study in North-East Netherlands

E.J.M. Siemerink
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
M. Schaapveld
- Comprehensive Cancer Centre North-East (IKNO), P.O. Box 330, 9700 AH, Groningen, The Netherlands
- Present address: The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
J.T.M. Plukker
- Department of Surgery, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
N.H. Mulder
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
G.A.P. Hospers
- Department of Medical Oncology, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- Corresponding author. Tel.: +31 50 361 2821; fax: +31 50 361 4862.

Accepted 22 March 2010.

Abstract

Background

Surgical resection is an important factor in the curative treatment of gastric cancer. However a variety of aspects of surgical treatment that potentially influence outcome are still not well defined. This study aims to assess the influence of hospital type, referral pattern and proximal or distal location of the tumour on the ultimate survival.

Methods

From January 1994 to January 2007, a total of 5245 patients were diagnosed with gastric adenocarcinoma in the region of the Comprehensive Cancer Centre North-East Netherlands. Hospitals in this region were categorized into three types: teaching university (TU), teaching non-university (TNU), and non-teaching hospitals (NT). The influence of hospital type, referral for surgery and location of the tumour on the relative survival of operated patients was studied.

Results

Of the 5245 patients, 2334 patients underwent surgery. For operated patients, the 5-year relative survival was 42.5% for the TU versus 34.0% and 35.5% for respectively TNU and NT hospitals (p = 0.064), with no difference (p = 0.38) in relative survival (25.6–31.9%) in the proximal tumours. A significant difference was found between the hospitals in the 5-year relative survival in the distal tumours; 59.7% in the TU versus 36.4% in the TNU and 36% in the NT (p = 0.03 univariate), however this was not confirmed in the multivariate analysis (p = 0.184). High referral centres did not perform better as far as survival is concerned than low referral hospitals.

In conclusion the hospital type in our region did not significantly influence outcome of surgery for gastric cancer.

Keywords: Gastric cancer, Population North-East Netherlands, Outcome, Hospital type, Hospital volume, Referral pattern