Year 2009 / Volume 101 / Number 10
Original
Management and outcomes in digestive cancer surgery: design and initial results of a multicenter cohort study

pp. 680-696

Espallargues, M. / Almazán, C. / Tebé, C. / Pla, R. / Pons, J. M. V. / Sánchez, E. / Mias, M. / Alomar, S. / Borrás, J. M. / por el Grupo de Estudio ONCOrisc

Abstract
Background: most studies that analyze the influence of structure factors on clinical outcomes are retrospective, based on clinical-administrative databases, and mainly focusing on surgical volume.
Objective: to study variations in the process and outcomes of oncologic surgery for esophagus, stomach, pancreas, liver metastases and rectum cancers in Catalonia, as well as the factors associated with these variations.
Patients and method: a retrospective (2002) and prospective (2003-05) multicenter cohort study. Data forms were designed to collect patient, process, and care outcome characteristics before surgery, at hospital discharge, and at 3 and 6 months after discharge. Main outcome measures were hospital and follow-up mortality, complications, re-interventions, and relapse rates.
Results: 49 hospitals (80%) participated in the retrospective phase, 44 of which (90%) also participated in the prospective phase: 3,038 patients (98%) were included. No differences were observed in the profile of operated patients according to hospital level of complexity, but clinical-pathological staging and other functional status variables could not be assessed because of over 20% of missing values. There was significant variability in the volume of interventions as well as in certain aspects of the healthcare process depending on type of cancer and center complexity. High rates of esophageal cancer mortality (18.2% at discharge, 27.3% at 6 months) and of complications and re-interventions for all cancers assessed, especially rectal cancer (18.4% re-interventions at 6 months), were identified.
Conclusions: the study of the variability identified will require adequate risk-adjustment and should take into account different structure factors. It is necessary that information included in medical records be improved.
Share Button
New comment
Comments
No comments for this article
Related articles
Citation tools
Espallargues, M. / Almazán, C. / Tebé, C. / Pla, R. / Pons, J. M. V. / Sánchez, E. / Mias, M. / Alomar, S. / Borrás, J. M. / por el Grupo de Estudio ONCOrisc. Management and outcomes in digestive cancer surgery: design and initial results of a multicenter cohort study. 680-696


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 731 visits.
This article has been downloaded 7 times.
Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology