Adherence with operative standards in the treatment of gastric cancer in the United States
| Autor: | Sarah L. Blair, Andrew M. Lowy, Beiqun Zhao, Matthew H.G. Katz, Kaitlyn J. Kelly |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.medical_treatment Adenocarcinoma law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Gastrectomy Stomach Neoplasms law Surgical oncology Internal medicine medicine Humans Practice Patterns Physicians' Stage (cooking) Aged Retrospective Studies Aged 80 and over business.industry Gastroenterology Cancer General Medicine Middle Aged Prognosis medicine.disease Survival Rate Clinical trial Oncology 030220 oncology & carcinogenesis Practice Guidelines as Topic Lymph Node Excision Pacific islanders Female 030211 gastroenterology & hepatology Guideline Adherence business Follow-Up Studies Abdominal surgery |
| Zdroj: | Gastric Cancer. 23:550-560 |
| ISSN: | 1436-3305 1436-3291 |
| Popis: | Despite multiple clinical trials and practice guidelines for the treatment of gastric cancer, oncologic outcomes have not improved in the United States. One potential reason could be differences in the quality of surgery as performed in a controlled trial versus in practice. Using the National Cancer Database, rates of adherence with operative standards for gastrectomy for cancer were analyzed. Of the numerous evidence-based operative standards outlined in the manual, two were reliably measured in the NCDB: (1) achieving and R0 resection, and (2) having > 16 lymph nodes examined. Univariable and multivariable Cox proportional hazard modeling and logistic regression were performed. A total of 28,705 patients with gastric adenocarcinoma who underwent curative-intent gastrectomy during 2004–2014 were identified. Only 36.5% of stage 0/I patients, and 41.8% of stage II/III patients, met minimum standards. Predictors for meeting standards included age |
| Databáze: | OpenAIRE |
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