{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:25:31Z","timestamp":1790753131508,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"13","license":[{"start":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T00:00:00Z","timestamp":1534896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,11,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Centralization of surgery has been shown to improve outcomes for oesophageal and pancreatic cancer, and has been implemented for gastric cancer since 2012 in the Netherlands. This study evaluated the impact of centralizing gastric cancer surgery on outcomes for all patients with gastric cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients diagnosed with non-cardia gastric adenocarcinoma in the intervals 2009\u20132011 and 2013\u20132015 were selected from the Netherlands Cancer Registry. Clinicopathological data, treatment characteristics and mortality were assessed for the periods before (2009\u20132011) and after (2013\u20132015) centralization. Cox regression analyses were used to assess differences in overall survival between these intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 7204 patients were included. Resection rates increased slightly from 37\u00b76 per cent before to 39\u00b76 per cent after centralization (P =\u00a00\u00b7023). Before centralization, 50\u00b71 per cent of surgically treated patients underwent gastrectomy in hospitals that performed fewer than ten procedures annually, compared with 9\u00b72 per cent after centralization. Patients who had gastrectomy in the second interval were younger and more often underwent total gastrectomy (29\u00b73 per cent before versus 41\u00b72 per cent after centralization). Thirty-day postoperative mortality rates dropped from 6\u00b75 to 4\u00b71 per cent (P =\u00a00\u00b7004), and 90-day mortality rates decreased from 10\u00b76 to 7\u00b72 per cent (P =\u00a00\u00b7002). Two-year overall survival rates increased from 55\u00b74 to 58\u00b75 per cent among patients who had gastrectomy (P =\u00a00\u00b7031) and from 27\u00b71 to 29\u00b76 per cent for all patients (P =\u00a00\u00b7003). Improvements remained after adjustment for case mix; however, adjustment for hospital volume attenuated this association for surgically treated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Centralization of gastric cancer surgery was associated with reduced postoperative mortality and improved survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.10931","type":"journal-article","created":{"date-parts":[[2018,8,22]],"date-time":"2018-08-22T12:38:01Z","timestamp":1534941481000},"page":"1807-1815","source":"Crossref","is-referenced-by-count":93,"title":["Overall survival before and after centralization of gastric cancer surgery in the Netherlands"],"prefix":"10.1093","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9218-7639","authenticated-orcid":false,"given":"M","family":"van Putten","sequence":"first","affiliation":[{"name":"Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-0731","authenticated-orcid":false,"given":"S D","family":"Nelen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V E P P","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands"},{"name":"Department of Public Health, Erasmus MC \u2013 University Medical Centre Rotterdam, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H M B","family":"Stoot","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zuyderland Medical Centre, Sittard-Geleen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H H","family":"Hartgrink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S S","family":"Gisbertz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E J","family":"Spillenaar Bilgen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Heisterkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R H A","family":"Verhoeven","sequence":"additional","affiliation":[{"name":"Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G A P","family":"Nieuwenhuijzen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,8,22]]},"reference":[{"key":"2021020616454859700_bjs10931-bib-0001","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/apt.12814","article-title":"Review article: the epidemiology and prevention of gastric cancer","volume":"40","author":"Fock","year":"2014","journal-title":"Aliment Pharmacol Ther"},{"key":"2021020616454859700_bjs10931-bib-0002","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1016\/j.ejca.2015.07.026","article-title":"EUROCARE-5 Working Group. 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