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Trends in the Surgical Treatment of Gastric Adenocarcinoma

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

In past decade, the treatment of gastric adenocarcinoma has evolved as a result of the publication of two seminal randomized controlled trials. We aimed to examine treatment trends for resectable gastric cancer (stage I–III) using the National Cancer Data Base (NCDB). Our hypothesis was that the use of chemotherapy and chemoradiotherapy in addition to surgery for the treatment of gastric adenocarcinoma has increased from 2000 to 2009.

Methods

Patients diagnosed with stage I–III gastric adenocarcinoma between 2000 and 2009 were selected from the NCDB Hospital Comparison Benchmark Reports. Attention was paid to the initial treatment regimen and data on hospital setting were collected and analyzed. The Cochran–Armitage test for trend was used to assess changes in treatment over time.

Results

A total of 50,778 patients with stage I–III gastric adenocarcinoma were included in the analysis. Between 2000 and 2009, the use of surgery alone decreased significantly across all three stages at both teaching hospitals and community hospitals (p < 0.0001 for all cases). In the same period, the use of chemotherapy in addition to surgery increased significantly across all three stages and at both hospital settings (p < 0.0001 for all cases). Surgery plus chemoradiotherapy increased for stage I–III disease at community hospitals (p < 0.05 for all) but only increased significantly for stage II disease at teaching hospitals (p < 0.01). Incidentally, nonsurgical treatment increased across all three stages at both hospital settings (p < 0.001 for all cases).

Conclusions

Data from the NCDB from 2000 to 2009 demonstrate that there has been an increasing use of chemotherapy in addition to surgery for resectable gastric cancer.

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Acknowledgment

SR would like to thank the Case Western Reserve University School of Medicine for providing support with the Dean’s Summer Research Award for first-year medical students.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA

    Siavash Raigani BA, Jeffrey M. Hardacre MD, Julian Kim MD & John B. Ammori MD

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  1. Siavash Raigani BA
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  2. Jeffrey M. Hardacre MD
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  3. Julian Kim MD
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  4. John B. Ammori MD
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Corresponding author

Correspondence to John B. Ammori MD.

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Raigani, S., Hardacre, J.M., Kim, J. et al. Trends in the Surgical Treatment of Gastric Adenocarcinoma. Ann Surg Oncol 21, 569–574 (2014). https://doi.org/10.1245/s10434-013-3314-x

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  • DOI: https://doi.org/10.1245/s10434-013-3314-x

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