Long-term Outcomes of Gastric Cancer in a Small Institute: a Single Surgeon Experience
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ORIGINAL ARTICLE
Long-term Outcomes of Gastric Cancer in a Small Institute: a Single Surgeon Experience Ji Yoon Jeong 1 & Kwang Hee Kim 1 & Sang Hyuk Seo 1 Sang Hoon Oh 1
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& Min Sung An & HyungJoo Baik & Jin Soo Kim & Ki Hoon Kim &
Received: 6 June 2020 / Accepted: 29 October 2020 # Association of Surgeons of India 2020
Abstract The aim of our study was to analyze the short-term and long-term outcomes of gastric cancer patients who underwent surgical treatment in a small, single institute by one surgeon. We retrospectively reviewed the medical records of 950 patients who underwent surgical treatment for gastric cancer between January 2000 and January 2010 at Dong-rae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. A total of 820 patients were included and analyzed. We divided the time period into 2 groups: 2000–2005 (period 1) and 2006–2010 (period 2). Since all of the surgeries were performed by a single surgeon, we were able to analyze the effect of increasing individual surgeon experience. The mean follow-up period was 78.26 months. The 5-year overall survival and relapse-free survival rates of all of the patients were 84.6% and 86.5%, respectively; the postoperative morbidity and mortality rates were 12% and 0.36%, respectively. The relapse-free survival rate was higher in period 2 than in period 1 (82.9% vs 90.2%, p = 0.002). The results of gastric cancer surgery between a small institute and the large institutes were comparable. The increased proportion of early gastric cancer and individual surgeon experience was associated with the improvement in the long-term oncologic outcomes of gastric cancer treatment. Keywords Gastric cancer . Surgeon volume . Surgeon experience . Long-term outcome
Background Numerous developments have been made in surgical techniques and adjuvant chemotherapy for gastric cancer. However, gastric cancer remains the fourth most common cause of cancer-related death worldwide [1]. Its treatment requires a complex surgical procedure and multidisciplinary
Ji Yoon Jeong, Kwang Hee Kim and Sang Hyuk Seo contributed equally to this work. Ji Yoon Jeong and Kwang Hee Kim are co-first authors. * Sang Hyuk Seo [email protected] 1
Department of Surgery, Busan Paik Hospital, Inje University, Bokgiro 75, Busanjin-gu, Busan, Republic of Korea
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Department of Surgery, Haeundae Paik Hospital, Inje University, Busan, Republic of Korea
treatment, but high mortality and relapse rates are important problems that must be overcome. To improve the quality of gastric cancer treatment, studies concerning volume-outcome relationships have been ongoing since 1990. It has been reported that hospital volume has a positive relationship with clinical outcomes [2]. Based on these studies, Western countries, such as the USA, the UK, Australia, the Netherlands, and Sweden, started a policy for the centralization of cancer treatment in high-volume centers [3–7]. However, there have been only a limited number of studies concerning the relationship between the size of hospi
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