Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Decreasing resection rates for nonmetastatic gastric cancer in Europe and the United States

Huang, Lei ; Jansen, Lina ; Balavarca, Yesilda ; Verhoeven, Rob H A LU ; Ruurda, Jelle P ; Van Eycken, Liesbet ; De Schutter, Harlinde ; Johansson, Jan LU orcid ; Lindblad, Mats and Johannesen, Tom B , et al. (2020) In Clinical and Translational Medicine 10(6). p.1-15
Abstract

BACKGROUND: Resection is the cornerstone of curative treatment for many nonmetastatic gastric cancers (GCs), but the population treatment patterns remains largely unknown. This large international population-based study aimed at investigating the treatment patterns and trends for nonmetastatic GC in Europe and the United States and at exploring factors associated with resection.

METHODS: Data of patients with microscopically confirmed primary invasive GC without distant metastasis from the national cancer registries of the Netherlands, Belgium, Sweden, Norway, Slovenia, and Estonia and the US Surveillance, Epidemiology, and End Results (SEER)-18 Program were retrieved. Age-standardized treatment rates were computed and trends were... (More)

BACKGROUND: Resection is the cornerstone of curative treatment for many nonmetastatic gastric cancers (GCs), but the population treatment patterns remains largely unknown. This large international population-based study aimed at investigating the treatment patterns and trends for nonmetastatic GC in Europe and the United States and at exploring factors associated with resection.

METHODS: Data of patients with microscopically confirmed primary invasive GC without distant metastasis from the national cancer registries of the Netherlands, Belgium, Sweden, Norway, Slovenia, and Estonia and the US Surveillance, Epidemiology, and End Results (SEER)-18 Program were retrieved. Age-standardized treatment rates were computed and trends were evaluated using linear regression. Associations of resection with patient and tumor characteristics were analyzed using multivariable-adjusted log-binomial regression. Analysis was performed in each country respectively without pooling.

RESULTS: Together 65 707 nonmetastatic GC patients diagnosed in 2003-2016 were analyzed. Age-standardized resection rates significantly decreased over years in all countries (by 4-24%). In 2013-2014, rates varied greatly from 54 to 75%. Patients with increasing ages, cardia cancers, or cancers invading adjacent structure were significantly less frequently resected. Resection was further associated with sex, performance status, comorbidities, tumor histology, tumor size, hospital type, and hospital volume. Association patterns and strengths varied across countries. After multivariable adjustment, resection rates remained decreasing (prevalence ratio = 0.97-0.995 per year), with decreasing trends consistently seen in various subgroups.

CONCLUSIONS: Nonmetastatic GCs were less frequently resected in Europe and the United States in the early 21st century. Resection rates varied greatly across countries and appeared not to be optimal. Various factors associated with resection were revealed. Our findings can help to identify differences and possibly modifiable places in clinical practice and provide important novel references for designing effective population-based GC management strategies. In Europe and the United States, nonmetastatic gastric cancers were less frequently resected in the early 21st century. Resection rates varied greatly across countries and appeared not optimal. Various factors associated with resection were revealed. Our findings identify differences and possibly modifiable places in clinical practice and provide important novel references for designing effective population-based management strategies.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical and Translational Medicine
volume
10
issue
6
article number
e203
pages
1 - 15
publisher
Wiley
external identifiers
  • pmid:33135354
ISSN
2001-1326
DOI
10.1002/ctm2.203
language
English
LU publication?
yes
additional info
© 2020 The Authors. Clinical and Translational Medicine published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.
id
c4e32eaf-814b-44a8-83d0-832fac59dcc4
date added to LUP
2022-05-31 16:20:13
date last changed
2022-07-04 13:15:49
@article{c4e32eaf-814b-44a8-83d0-832fac59dcc4,
  abstract     = {{<p>BACKGROUND: Resection is the cornerstone of curative treatment for many nonmetastatic gastric cancers (GCs), but the population treatment patterns remains largely unknown. This large international population-based study aimed at investigating the treatment patterns and trends for nonmetastatic GC in Europe and the United States and at exploring factors associated with resection.</p><p>METHODS: Data of patients with microscopically confirmed primary invasive GC without distant metastasis from the national cancer registries of the Netherlands, Belgium, Sweden, Norway, Slovenia, and Estonia and the US Surveillance, Epidemiology, and End Results (SEER)-18 Program were retrieved. Age-standardized treatment rates were computed and trends were evaluated using linear regression. Associations of resection with patient and tumor characteristics were analyzed using multivariable-adjusted log-binomial regression. Analysis was performed in each country respectively without pooling.</p><p>RESULTS: Together 65 707 nonmetastatic GC patients diagnosed in 2003-2016 were analyzed. Age-standardized resection rates significantly decreased over years in all countries (by 4-24%). In 2013-2014, rates varied greatly from 54 to 75%. Patients with increasing ages, cardia cancers, or cancers invading adjacent structure were significantly less frequently resected. Resection was further associated with sex, performance status, comorbidities, tumor histology, tumor size, hospital type, and hospital volume. Association patterns and strengths varied across countries. After multivariable adjustment, resection rates remained decreasing (prevalence ratio = 0.97-0.995 per year), with decreasing trends consistently seen in various subgroups.</p><p>CONCLUSIONS: Nonmetastatic GCs were less frequently resected in Europe and the United States in the early 21st century. Resection rates varied greatly across countries and appeared not to be optimal. Various factors associated with resection were revealed. Our findings can help to identify differences and possibly modifiable places in clinical practice and provide important novel references for designing effective population-based GC management strategies. In Europe and the United States, nonmetastatic gastric cancers were less frequently resected in the early 21st century. Resection rates varied greatly across countries and appeared not optimal. Various factors associated with resection were revealed. Our findings identify differences and possibly modifiable places in clinical practice and provide important novel references for designing effective population-based management strategies.</p>}},
  author       = {{Huang, Lei and Jansen, Lina and Balavarca, Yesilda and Verhoeven, Rob H A and Ruurda, Jelle P and Van Eycken, Liesbet and De Schutter, Harlinde and Johansson, Jan and Lindblad, Mats and Johannesen, Tom B and Zadnik, Vesna and Žagar, Tina and Mägi, Margit and Bastiaannet, Esther and Lagarde, Sjoerd M and van de Velde, Cornelis J H and Schrotz-King, Petra and Brenner, Hermann}},
  issn         = {{2001-1326}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1--15}},
  publisher    = {{Wiley}},
  series       = {{Clinical and Translational Medicine}},
  title        = {{Decreasing resection rates for nonmetastatic gastric cancer in Europe and the United States}},
  url          = {{http://dx.doi.org/10.1002/ctm2.203}},
  doi          = {{10.1002/ctm2.203}},
  volume       = {{10}},
  year         = {{2020}},
}