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Quality indicators for gastric cancer surgery: a survey of practicing pathologists in Ontario.

https://arctichealth.org/en/permalink/ahliterature151139
Source
Ann Surg Oncol. 2009 Jul;16(7):1883-9
Publication Type
Article
Date
Jul-2009
Author
Alia P Qureshi
C Andrea Ottensmeyer
Alyson L Mahar
Runjan Chetty
Aaron Pollett
Frances C Wright
Natalie G Coburn
Author Affiliation
Division of General Surgery, University of Toronto, Toronto, ON, Canada.
Source
Ann Surg Oncol. 2009 Jul;16(7):1883-9
Date
Jul-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Female
Gastrectomy - standards
Humans
Lymph Node Excision
Lymph Nodes - pathology
Lymphatic Metastasis
Male
Middle Aged
Ontario
Pathology - standards
Quality Indicators, Health Care
Stomach - pathology
Stomach Neoplasms - pathology - surgery
Abstract
Adequate lymph node (LN) assessment and R0 resection are critical to the staging and management of gastric cancer. The American Joint Committee on Cancer/International Union Against Cancer recommend at least 15 LN be assessed, and the literature suggests a gross disease-free margin of 5-6 cm be achieved. Results of an Ontario general surgeons' survey indicated these standards were not widely known. Because disease management is highly collaborative, we surveyed pathologists to assess their knowledge of LN assessment and margins for processing gastric cancer specimens.
Pathologists were identified by the College of Physicians and Surgeons of Ontario and MD Select databases. Participants were surveyed online or by mail.
Pathologists indicated a goal of assessing 20 LN (11%). Most self-reported an actual assessment of 5-10 LN (49%), with 88% reporting a number below current standards. Additionally, 54% of responding pathologists identified >1 cm as an adequate gross margin, and 89% of pathologists indicated a response below current standards. Ninety-four percent of pathologists agreed that more education on gastric cancer is valuable.
To improve the quality of gastric cancer management, our findings suggest the need for clear, consistent guidelines for adequate gross margin resection length. Furthermore, there is a critical need for education aimed at closing the knowledge gap among practicing pathologists and surgeons regarding current recommended guidelines for LN assessment and adequate margin length.
PubMed ID
19421818 View in PubMed
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Surgeons' knowledge of quality indicators for gastric cancer surgery.

https://arctichealth.org/en/permalink/ahliterature159715
Source
Gastric Cancer. 2007;10(4):205-14
Publication Type
Article
Date
2007
Author
Lucy K Helyer
Catherine O'Brien
Natalie G Coburn
Carol J Swallow
Author Affiliation
Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2M9, Canada.
Source
Gastric Cancer. 2007;10(4):205-14
Date
2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Clinical Competence
Combined Modality Therapy
Female
Gastrectomy - standards
General Surgery - standards
Humans
Lymph Node Excision - standards
Male
Middle Aged
Neoplasm Staging - standards
Ontario
Palliative Care
Physicians - standards
Quality Indicators, Health Care
Questionnaires
Stomach Neoplasms - surgery - therapy
Abstract
Gastric cancer survival in the West is inferior to that achieved in Asian centers. While differences in tumor biology may play a role, poor quality surgery likely contributes to understaging. We hypothesize that the majority of surgeons performing gastric cancer surgery in North America are unaware of the recommended standards.
Using the Ontario College of Physicians and Surgeons registry, surgeons who potentially included gastric cancer surgery in their scope of practice were identified. A questionnaire was mailed to 559; of those, 206 surgeons reported managing gastric cancer. Results were evaluated by chi(2) and logistic regression; P
PubMed ID
18095075 View in PubMed
Less detail