Evidence map›Paper›PMID 30302654›Full record

Observational studyGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2019

Effect of hospital and surgeon volume on postoperative outcomes after distal gastrectomy for gastric cancer based on data from 145,523 Japanese patients collected from a nationwide web-based data entry system.

Masaaki Iwatsuki, Hiroyuki Yamamoto, Hiroaki Miyata, Yoshihiro Kakeji, Kazuhiro Yoshida, Hiroyuki Konno, Yasuyuki Seto, Hideo Baba

Open access · bronzeAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 1 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.

  1. Pooled it
  2. Phase II study of S-1 and oxaliplatin as neoadjuvant chemotherapy for locally advanced adenocarcinoma of the gastric or esophagogastric junction: KSCC1601.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2022
    Trial
  3. Beyond 30-day mortality: causes and risk factors of half-year postdischarge mortality after gastric cancer surgery.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Article
  4. Review
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  18. TREATMENT OF GASTRIC CANCER ACCORDING TO THE COMPLEXITY OF THE HOSPITAL ONCOLOGY UNIT: ANALYSIS OF 33,774 PATIENTS OVER TWO DECADES.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Masaaki IwatsukiDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Hiroyuki YamamotoDepartment of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroaki MiyataDepartment of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Yoshihiro KakejiDatabase Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Kazuhiro YoshidaDepartment of Surgical Oncology, Gifu University School of Medicine, Gifu, Japan.
Hiroyuki KonnoHamamatsu University School of Medicine, Hamamatsu, Japan.
Yasuyuki SetoThe Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
Hideo BabaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. hdobaba@kumamoto-u.ac.jp.ORCID http://orcid.org/0000-0002-3474-2550
Keio University · JPKumamoto University · JPThe Japanese Society of Gastroenterological Surgery · JPGifu University · JPHamamatsu University School of Medicine · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite interest in surgeon and hospital volume effects on distal gastrectomy, clinical significance has not been confirmed in a large-scale population. We studied to clarify the effects of surgeon and hospital volume on postoperative mortality after distal gastrectomy for gastric cancer among Japanese patients in a nationwide web-based data entry system.

methodsWe extracted data on distal gastrectomy for gastric cancer from the National Clinical Database between 2011 and 2015. The primary outcome was operative mortality. Hospital volume was divided into 3 tertiles: low (1-22 cases per year), medium (23-51) and high (52-404). Surgeon volume was divided into the 5 groups: 0-3, 4-10, 11-20, 21-50, 51 + cases per year. We calculated the 95% confidence interval (CI) for the mortality rate based on odds ratios (ORs) estimated from a hierarchical logistic regression model.

resultsWe analyzed 145,523 patients at 2182 institutions. Operative mortality was 1.9% in low-, 1.0% in medium- and 0.5% in high-volume hospitals. The operative mortality rate decreased definitively with surgeon volume, 1.6% in the 0-3 group and 0.3% in the 51 + group. After risk adjustment for surgeon and hospital volume and patient characteristics, hospital volume was significantly associated with operative morality (medium: OR 0.64, 95% CI 0.56-0.73, P < 0.001; high: OR 0.42, 95% CI 0.35-0.51, P < 0.001).

conclusionsWe demonstrate that hospital volume can have a crucial impact on postoperative mortality after distal gastrectomy compared with surgeon volume in a nationwide population study. These findings suggest that centralization may improve outcomes after distal gastrectomy.

Indexed as

AdultAgedAged, 80 and overClinical CompetenceDatabases, FactualFemaleGastrectomyHospitals, High-VolumeHumansJapanMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsStomach NeoplasmsDistal gastrectomyGastric cancerHospital volume

Identifiers

PMID30302654
OpenAlexW2897426271

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.