Is there a difference in utilization of a perioperative treatment approach for gastric cancer between safety net hospitals and tertiary referral centers?
| Autor: | Michael K. Turgeon, Manuel Fernandez, Harry M. Richter, Neha Goel, Jessica M Keilson, Ajay V. Maker, Rodrigo E. Alterio, Annie Wang, Rachel M. Lee, Maria C. Russell, Ann Y. Lee, Michelle R. Ju, Jashodeep Datta, Shishir K. Maithel, Joshua P. Kronenfeld, Matthew R. Porembka |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Adjuvant chemotherapy medicine.medical_treatment perioperative therapy Tertiary Care Centers 0302 clinical medicine Stage (cooking) Cancer General Medicine Middle Aged Prognosis Neoadjuvant Therapy Oncology 030220 oncology & carcinogenesis 6.1 Pharmaceuticals 030211 gastroenterology & hepatology Female Asian race medicine.medical_specialty Referral safety net hospitals Clinical Trials and Supportive Activities Oncology and Carcinogenesis Stage ii Article Perioperative Care 03 medical and health sciences Rare Diseases Stomach Neoplasms Gastrectomy Clinical Research Internal medicine medicine Humans Oncology & Carcinogenesis Retrospective Studies Aged Quality of Health Care health disparities Chemotherapy business.industry gastric cancer Evaluation of treatments and therapeutic interventions Perioperative medicine.disease Surgery business Digestive Diseases Safety-net Providers Follow-Up Studies |
| Zdroj: | Journal of surgical oncology, vol 124, iss 4 J Surg Oncol |
| Popis: | BACKGROUND AND OBJECTIVES: Perioperative therapy is a favored treatment strategy for gastric cancer. We sought to assess utilization of this approach at safety net hospitals (SNH) and tertiary referral centers (TRC). MATERIALS AND METHODS: Patients in the US Safety Net Collaborative (2012–2014) with resectable gastric cancer across five SNH and their sister TRC were included. Primary outcomes were receipt of neoadjuvant chemotherapy (NAC) and perioperative therapy. RESULTS: Of 284 patients, 36% and 64% received care at SNH and TRC. The distribution of Stage II/III resectable disease was similar across facilities. Receipt of NAC at SNH and TRC was similar (56% vs. 46%, p = 0.27). Compared with overall clinical stage, 38% and 36% were pathologically downstaged at SNH and TRC, respectively. Among patients who received NAC, those who also received adjuvant chemotherapy at SNH and TRC were similar (66% vs. 60%, p = 0.50). Asian race and higher clinical stage were associated with receipt of perioperative therapy (both p < 0.05) while treatment facility type was not. CONCLUSIONS: There was no difference in utilization of a perioperative treatment strategy between facility types for patients with gastric cancer. Pathologic down-staging from NAC was similar across treatment facilities, suggesting similar quality and duration of therapy. Treatment at an SNH is not a barrier to receiving standard-of-care perioperative therapy for gastric cancer. |
| Databáze: | OpenAIRE |
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