Evidence-Based Practice Use Increases for Gastric Cancer Surgery


The adoption of evidence-based surgical practices have influenced treatment patterns for gastric cancer in the United States, according to research published in Cancer (online December 6, 2017; doi:10.1002/cncr.31179).

However, certain recommended surgical practices, particularly with regard to metastatic disease, remain underutilized, according to researchers.

Matthew R Porembka, MD, assistant professor of surgery at UT Southwestern Medical Center (Dallas, TX), and colleagues retrospectively studied patients surgically treated for gastric adenocarcinoma between 2006 and 2014. Patients were grouped based on disease stage, which the researchers defined as early-stage (stage IA), locally advanced (stage IB-IIIC), and metastatic (stage IV).

Treatment selection was examined based on tumor stage and location. The study, which identified individuals through the National Cancer Database, included data from 89,098 patients.

Among patients with early-stage cancer, researchers found that the use of recommended endoscopic treatments increased over time for patients with cardia and noncardia disease.


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In the locally advanced disease state, preoperative treatments increased for patients for cardia patients (odds ratio [OR] for 2013-2014, 3.09; 95% CI, 2.80-3.41; 2006-2008 period as reference) and noncardia patients (OR, 3.32; 95% CI, 2.88-3.82). For patients with noncardia disease, the use of perioperative treatment increased over the use of postoperative treatment (OR, 4.21 vs 0.66).

Researchers observed that 34% of patients with metastatic cardia disease and 40% of patients with metastatic noncardia disease received no treatment, despite the existence of evidence-based treatment recommendations.Cameron Kelsall