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The National Cancer Data Base report on gastric carcinoma
S A Hundahl1, H R Menck, E G Mansour
1Department of Surgery, The Queen's Medical Center, Honolulu, Hawaii, USA.
Cancer
|December 24, 1997
Summary
This study analyzed gastric carcinoma treatment patterns from the National Cancer Data Base (NCDB). Survival rates varied by stage, and treatment for elderly patients remains a challenge.
Area of Science:
- Oncology
- Cancer Epidemiology
- Health Services Research
Background:
- The National Cancer Data Base (NCDB) is a significant electronic registry system in the U.S., capturing nearly 60% of incident cancers.
- NCDB facilitates outcomes management on local and national scales, in conjunction with American College of Surgeons Commission on Cancer programs.
Purpose of the Study:
- To analyze patterns of care and survival outcomes for gastric carcinoma using NCDB data.
- To identify trends and variations in treatment for gastric cancer patients.
Main Methods:
- Analysis of 57,407 gastric carcinoma cases from the NCDB (1985-1993).
- Focus on 5-year relative survival for 1987-1988 cases staged by AJCC TNM classification.
- Examination of patterns of care for 1992-1993 cases.
Main Results:
- Five-year relative survival rates for the 1987-1988 cohort ranged from 71% (Stage IA) to 5% (Stage IV).
- Slight increase in total gastrectomy, with continued use of proximal gastrectomy for proximal cancers.
- A decline in postoperative adjuvant treatment and a notable proportion of patients receiving no cancer treatment due to age or infirmity.
Conclusions:
- Unexplained variations in gastric cancer treatment exist, indicating room for improvement.
- Treatment approaches for elderly and infirm gastric carcinoma patients present significant challenges.