Chan Young Kim1,2, Byung-Ho Nam1,3, Gyu Seok Cho1,4, Woo Jin Hyung1,5, Min Chan Kim1,6, Hyuk-Joon Lee1,7, Keun Won Ryu1,8, Sung Wan Ryu1,9, Dong Woo Shin1,10, Jun Ho Lee11,12. 1. Center for Gastric Cancer, Gastric Cancer Branch, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang, Gyeonggi, 411-769, Korea. 2. Department of Surgery, Chonbuk National University, Jeonju, Korea. 3. Center for Clinical Trial, National Cancer Center, Goyang, Korea. 4. Department of Surgery, Soonchunhayng University, Cheonan, Korea. 5. Department of Surgery, Yonsei University, Seoul, Korea. 6. Department of Surgery, Dong-a University, Busan, Korea. 7. Department of Surgery, Seoul National University, Seoul, Korea. 8. Gastric Cancer Branch, National Cancer Center, Goyang, Korea. 9. Department of Surgery, Kemyeong University, Daegu, Korea. 10. Department of Surgery, Jaeseng Hospital, Seongnam, Korea. 11. Center for Gastric Cancer, Gastric Cancer Branch, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang, Gyeonggi, 411-769, Korea. gsjunholee@gmail.com. 12. Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. gsjunholee@gmail.com.
Abstract
BACKGROUND: The aim of this study was to investigate learning curves for surgeons performing D2 lymph node dissection based on actual patient survival. METHODS: A total of 3,284 patients with gastric cancer who underwent curative intent gastric cancer surgery by nine surgeons in eight Korean hospitals between 2001 and 2006 were included. Each surgeon's experience was coded as the number of D1 + β or more gastrectomies performed before that for each patient, which indicates the surgeon's total number of prior surgical experiences. Surgeon experience was grouped into two sets of categories. The set of categories included four groups of experience: ≤50, 51-100, 101-200, and >200 applicable operations. Multivariate survival time regression models were used to evaluate the association between surgeon experience and overall survival. RESULTS: The learning curve for gastric cancer survival after open gastric cancer surgery was steep and did not reach a plateau until a surgeon completed 100 operations. Overall survival rate was the lowest among patients treated by a surgeon with an experience of 50-100 cases. The overall survival of patients at 5 years when the surgeon had a history of more than 100 experiences was higher in each stage than that when the surgeon had a history of fewer than 100 experiences. CONCLUSION: As a surgeon's experience increases, survival after gastric cancer surgery improves. Special attention needs to be paid to the second period of surgeon experience because survival of patients in this period was the lowest.
BACKGROUND: The aim of this study was to investigate learning curves for surgeons performing D2 lymph node dissection based on actual patient survival. METHODS: A total of 3,284 patients with gastric cancer who underwent curative intent gastric cancer surgery by nine surgeons in eight Korean hospitals between 2001 and 2006 were included. Each surgeon's experience was coded as the number of D1 + β or more gastrectomies performed before that for each patient, which indicates the surgeon's total number of prior surgical experiences. Surgeon experience was grouped into two sets of categories. The set of categories included four groups of experience: ≤50, 51-100, 101-200, and >200 applicable operations. Multivariate survival time regression models were used to evaluate the association between surgeon experience and overall survival. RESULTS: The learning curve for gastric cancer survival after open gastric cancer surgery was steep and did not reach a plateau until a surgeon completed 100 operations. Overall survival rate was the lowest among patients treated by a surgeon with an experience of 50-100 cases. The overall survival of patients at 5 years when the surgeon had a history of more than 100 experiences was higher in each stage than that when the surgeon had a history of fewer than 100 experiences. CONCLUSION: As a surgeon's experience increases, survival after gastric cancer surgery improves. Special attention needs to be paid to the second period of surgeon experience because survival of patients in this period was the lowest.
Authors: Andrew J Vickers; Fernando J Bianco; Angel M Serio; James A Eastham; Deborah Schrag; Eric A Klein; Alwyn M Reuther; Michael W Kattan; J Edson Pontes; Peter T Scardino Journal: J Natl Cancer Inst Date: 2007-07-24 Impact factor: 13.506
Authors: Jordan Levy; Vaibhav Gupta; Elmira Amirazodi; Catherine Allen-Ayodabo; Naheed Jivraj; Yunni Jeong; Laura E Davis; Alyson L Mahar; Charles De Mestral; Olli Saarela; Natalie Coburn Journal: Gastric Cancer Date: 2019-11-04 Impact factor: 7.370
Authors: Rossella Reddavid; William Allum; Karol Polom; Aridai Resendiz; Woo Jin Hyung; Paolo Kassab; Daniela Molena; Enrique Lanzarini; Masanori Terashima; Alberto Biondi; Richard Van Hilegersberg; Domenico D'Ugo; Uberto Fumagalli; Stefano Santi; Giovanni De Manzoni; Franco Roviello; Maurizio Degiuli Journal: Updates Surg Date: 2021-01-08
Authors: Tae-Han Kim; Keun Won Ryu; Jun Ho Lee; Gyu-Seok Cho; Woo Jin Hyung; Chan-Young Kim; Min-Chan Kim; Seung Wan Ryu; Dong Woo Shin; Hyuk-Joon Lee Journal: Gastric Cancer Date: 2019-03-04 Impact factor: 7.701