Evidence map›Paper›PMID 41483151›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2026

Comparative study of the short-term outcomes of gastric cancer surgery between Japanese Gastric cancer association-certified and non-certified institutions: a retrospective cohort analysis using a national database in Japan.

Tomoyuki Matsunaga, Hideki Endo, Hiroyuki Yamamoto, Koshi Kumagai, Shingo Kanaji, Hisato Kawakami, Chika Kusano, Ryoji Kushima, Mitsuhiro Fujishiro, Kensei Yamaguchi and 4 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Clinical advantages of robotic gastrectomy for gastric cancer over conventional laparoscopic approach: a retrospective cohort study using a nationwide registry database in Japan.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Article
  2. Article
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

14 authors.

Tomoyuki MatsunagaDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan. matut0m0@tottori-u.ac.jp.ORCID 0000-0003-4563-8940
Hideki EndoDepartment of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroyuki YamamotoDepartment of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Koshi KumagaiDepartment of Upper Gastrointestinal Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0374, Japan.
Shingo KanajiDivision of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, Japan.
Hisato KawakamiDepartment of Clinical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Chika KusanoDepartment of Gastroenterology, Kitasato University School of Medicine, Kanagawa, 252-0374, Japan.
Ryoji KushimaDepartment of Pathology, Shiga University of Medical Science, Otsu, Japan.
Mitsuhiro FujishiroDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kensei YamaguchiDepartment of Gastroenterological Chemotherapy, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan.
Takaki YoshikawaDepartment of Gastric Surgery, National Cancer Center Hospital, Chuo-Ku, Tokyo, Japan.
Yuichiro DokiDepartment of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Yoshihiro KakejiDivision of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe, Japan.
Yoshiyuki FujiwaraDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, 36-1 Nishi-Cho, Yonago, 683-8504, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study assessed the impact of an institutional certification system that was newly introduced by the Japanese Gastric Cancer Association on short-term surgical outcomes in patients with gastric cancer using data from the National Clinical Database.

methodsA retrospective cohort study of distal gastrectomy and total gastrectomy procedures performed between January 2020 and December 2022 was conducted. The institutions were classified into three categories: type A, type B, and non-certified institutions, in decreasing order of certification stringency. The primary outcome was the incidence of grade ≥ IIIa postoperative complications based on the Clavien-Dindo classification system. The secondary outcome was surgery-related mortality. Logistic regression with risk adjustment, estimated using generalized estimating equations, was used to account for intra-cluster correlation.

resultsThere was no significant difference in the risks of distal gastrectomy-related complications across the three institution types. However, type A- (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.31-0.49) and type B-certified institutions (OR 0.59, 95% CI 0.49-0.71) had a significantly lower mortality risk than non-certified ones. On the other hand, Type A- (OR 1.25, 95% CI 1.09-1.44) and type B-certified institutions (OR 1.17, 95% CI 1.03-1.33) had higher risks of postoperative total gastrectomy-related complications than non-certified ones. Nevertheless, type A- (OR 0.41, 95% CI 0.29-0.58) and type B-certified institutions (OR 0.67, 95% CI 0.51-0.88) had significantly lower surgery-related mortality risks than non-certified ones.

conclusionsCertified institutions demonstrated lower surgical mortality risks, highlighting the benefits of the certification system and the importance of institutional quality.

Indexed as

CertificationGastrectomyPostoperative ComplicationsStomach NeoplasmsAgedDatabases, FactualEast Asian PeopleFemaleHumansJapanMaleMiddle AgedRetrospective StudiesCertified institutionClinical databaseGastric cancerPostoperative complicationShort-term outcome

Identifiers

PMID41483151
PMCPMC12957089

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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.