Journal of Gastrointestinal Surgery

, Volume 11, Issue 4, pp 410–420 | Cite as

Treatment of Gastric Adenocarcinoma May Differ Among Hospital Types in the United States, a Report from the National Cancer Data Base

  • Kaye M. Reid-LombardoEmail author
  • Greer Gay
  • Lina Patel-Parekh
  • Jaffer A. Ajani
  • John H. Donohue
  • Gastric Patient Care Evaluation Group from the Commission on Cancer


The concept that complex surgical procedures should be performed at high-volume centers to improve surgical morbidity and mortality is becoming widely accepted. We wanted to determine if there were differences in the treatment of patients with gastric cancer between community cancer centers and teaching hospitals in the United States. Data from the 2001 Gastric Cancer Patient Care Evaluation Study of the National Cancer Data Base comprising 6,047 patients with gastric adenocarcinoma treated at 691 hospitals were assessed. The mean number of patients treated was larger at teaching hospitals (14/year) when compared to community centers (5–9/year) (p < 0.05). The utilization of laparoscopy and endoscopic ultrasonography were significantly more common at teaching centers (p < 0.01). Pathologic assessment of greater than 15 nodes was documented in 31% of specimen at community hospitals and 38% at teaching hospitals (p < 0.01). Adjusted for cancer stage, chemotherapy and radiation therapy were utilized with equal frequency at all types of treatment centers. The 30-day postoperative mortality was lowest at teaching hospitals (5.5%) and highest at community hospitals (9.9%) (p < 0.01). These data support previous publications demonstrating that patients with diseases requiring specialized treatment have lower operative mortality when treated at high-volume centers.


Gastric cancer Operative mortality Hospital volume Survival NCDB 



American Joint Committee on Cancer


Commission on Cancer


Community Hospital Cancer Program


Community Hospital Comprehensive Cancer Program


National Cancer Data Base


Patient Care Evaluation


Teaching Hospital Cancer Program


United States



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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Kaye M. Reid-Lombardo
    • 1
    Email author
  • Greer Gay
    • 2
  • Lina Patel-Parekh
    • 2
  • Jaffer A. Ajani
    • 3
  • John H. Donohue
    • 1
  • Gastric Patient Care Evaluation Group from the Commission on Cancer
  1. 1.Department of SurgeryMayo ClinicRochesterUSA
  2. 2.American College of Surgeons, Commission on CancerChicagoUSA
  3. 3.Department of Gastrointestinal Medical OncologyThe University of Texas, M.D. Anderson Cancer CenterHoustonUSA

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