BACKGROUND: Outcomes after oesophagectomy and gastrectomy vary considerably between hospitals. Possible explanations include differences in case mix, hospital volume and hospital type. The present study examined the distribution of oesophagectomies and gastrectomies between hospital types in the Netherlands, and the relationship between hospital type and outcome. METHODS: Data were obtained from the nationwide Netherlands Cancer Registry. Hospitals were categorized as university hospitals (UH), non-university teaching hospitals (NUTH) and non-university non-teaching hospitals (NUNTH). Hospital type-outcome relationships were analysed by Cox regression, adjusting for case mix, hospital volume, year of diagnosis and use of multimodal therapies. RESULTS: Between 1989 and 2009, 10 025 oesophagectomies and 14 221 gastrectomies for cancer were performed in the Netherlands. The percentage of oesophagectomies and gastrectomies performed in UH increased from 17·6 and 6·4 per cent respectively in 1989 to 44·1 and 12·9 per cent in 2009. After oesophagectomy, the 3-month mortality rate was 2·5 per cent in UH, 4·4 per cent in NUTH and 4·1 per cent in NUNTH (P = 0·006 for UH versus NUTH). After gastrectomy, the 3-month mortality rate was 4·9 per cent in UH, 8·9 per cent in NUTH and 8·7 per cent in NUNTH (P < 0·001 for UH versus NUTH). Three-year survival was also higher in UH than in NUTH and NUNTH. CONCLUSION: Oesophagogastric resections performed in UH were associated with better outcomes but, owing to variation in outcomes within hospital types, centres of excellence cannot be designated solely on hospital type. Detailed information on case mix and outcomes is needed to identify centres of excellence.
BACKGROUND: Outcomes after oesophagectomy and gastrectomy vary considerably between hospitals. Possible explanations include differences in case mix, hospital volume and hospital type. The present study examined the distribution of oesophagectomies and gastrectomies between hospital types in the Netherlands, and the relationship between hospital type and outcome. METHODS: Data were obtained from the nationwide Netherlands Cancer Registry. Hospitals were categorized as university hospitals (UH), non-university teaching hospitals (NUTH) and non-university non-teaching hospitals (NUNTH). Hospital type-outcome relationships were analysed by Cox regression, adjusting for case mix, hospital volume, year of diagnosis and use of multimodal therapies. RESULTS: Between 1989 and 2009, 10 025 oesophagectomies and 14 221 gastrectomies for cancer were performed in the Netherlands. The percentage of oesophagectomies and gastrectomies performed in UH increased from 17·6 and 6·4 per cent respectively in 1989 to 44·1 and 12·9 per cent in 2009. After oesophagectomy, the 3-month mortality rate was 2·5 per cent in UH, 4·4 per cent in NUTH and 4·1 per cent in NUNTH (P = 0·006 for UH versus NUTH). After gastrectomy, the 3-month mortality rate was 4·9 per cent in UH, 8·9 per cent in NUTH and 8·7 per cent in NUNTH (P < 0·001 for UH versus NUTH). Three-year survival was also higher in UH than in NUTH and NUNTH. CONCLUSION: Oesophagogastric resections performed in UH were associated with better outcomes but, owing to variation in outcomes within hospital types, centres of excellence cannot be designated solely on hospital type. Detailed information on case mix and outcomes is needed to identify centres of excellence.
Authors: Ines Gockel; Constantin Johannes Ahlbrand; Michael Arras; Elke Maria Schreiber; Hauke Lang Journal: Dig Dis Sci Date: 2015-07-16 Impact factor: 3.199
Authors: J Diers; P Baum; J C Wagner; H Matthes; S Pietryga; N Baumann; K Uttinger; C-T Germer; A Wiegering Journal: Gastric Cancer Date: 2021-02-12 Impact factor: 7.370
Authors: Bang Wool Eom; Keun Won Ryu; Byung-Ho Nam; Yunjin Park; Hyuk-Joon Lee; Min Chan Kim; Gyu Seok Cho; Chan Young Kim; Seung Wan Ryu; Dong Woo Shin; Woo Jin Hyung; Jun Ho Lee Journal: PLoS One Date: 2015-02-27 Impact factor: 3.240
Authors: Heleen S Snijders; Nicoline J van Leersum; Daan Henneman; Alexander C de Vries; Rob A E M Tollenaar; Anne M Stiggelbout; Michel W J M Wouters; Jan Willem T Dekker Journal: Ann Surg Oncol Date: 2015-02-18 Impact factor: 5.344
Authors: S D Nelen; L Heuthorst; R H A Verhoeven; F Polat; Ph M Kruyt; K Reijnders; F T J Ferenschild; J J Bonenkamp; J E Rutter; J H W de Wilt; E J Spillenaar Bilgen Journal: J Gastrointest Surg Date: 2017-08-16 Impact factor: 3.452