Treatment of gastric adenocarcinoma at a New Zealand centre: meeting the challenges of a low volume country.
Maori
New Zealand
gastrectomy
gastric cancer
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
30
07
2019
revised:
27
09
2019
accepted:
05
10
2019
pubmed:
2
11
2019
medline:
22
12
2020
entrez:
2
11
2019
Statut:
ppublish
Résumé
Surgical treatment of gastric cancer in New Zealand is challenging because of a low annual incidence of 400 patients and population dispersal over a wide area with little data on regional treatment trends and outcomes. This investigation was undertaken to evaluate the surgical outcomes of gastric cancer patients presenting to a single upper gastrointestinal centre (WDHB, Waitemata District Health Board) and to compare these to national and international standards. Data on 135 patients with histologically proven gastric adenocarcinoma presenting between January 2010 and December 2014 were reviewed and compared with nationally available procedural volume data. Sixty of 135 patients were resected (resection rate 44%) and 75 patients were managed with palliative chemotherapy/symptomatic care alone. Twenty-six patients (43%) received adjuvant or neoadjuvant chemotherapy and only two patients (3%) underwent laparoscopic resection. In resected patients, 90-day mortality was 1.6%, and 11 patients (18%) developed complications ≥ Clavien-Dindo grade 3. Fifty-two patients (87%) had ≥15 lymph nodes resected and 54 patients (90%) had a histological R While WDHB is an internationally low volume centre for gastric cancer, surgical outcomes benchmark satisfactorily to international standards. New Zealand's national treatment standards should set aspirational goals for gastric cancer treatment and have a clear strategy to address issues of surgical volume and national service provision.
Sections du résumé
BACKGROUND
Surgical treatment of gastric cancer in New Zealand is challenging because of a low annual incidence of 400 patients and population dispersal over a wide area with little data on regional treatment trends and outcomes. This investigation was undertaken to evaluate the surgical outcomes of gastric cancer patients presenting to a single upper gastrointestinal centre (WDHB, Waitemata District Health Board) and to compare these to national and international standards.
METHODS
Data on 135 patients with histologically proven gastric adenocarcinoma presenting between January 2010 and December 2014 were reviewed and compared with nationally available procedural volume data.
RESULTS
Sixty of 135 patients were resected (resection rate 44%) and 75 patients were managed with palliative chemotherapy/symptomatic care alone. Twenty-six patients (43%) received adjuvant or neoadjuvant chemotherapy and only two patients (3%) underwent laparoscopic resection. In resected patients, 90-day mortality was 1.6%, and 11 patients (18%) developed complications ≥ Clavien-Dindo grade 3. Fifty-two patients (87%) had ≥15 lymph nodes resected and 54 patients (90%) had a histological R
CONCLUSION
While WDHB is an internationally low volume centre for gastric cancer, surgical outcomes benchmark satisfactorily to international standards. New Zealand's national treatment standards should set aspirational goals for gastric cancer treatment and have a clear strategy to address issues of surgical volume and national service provision.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
81-85Informations de copyright
© 2019 Royal Australasian College of Surgeons.
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