{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:28:42Z","timestamp":1790494122753,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2011,4,20]],"date-time":"2011-04-20T00:00:00Z","timestamp":1303257600000},"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":[[2011,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The objective was to evaluate the impact of concentration of surgery for oesophageal and gastric cardia cancer on long-term survival in the population-based Eindhoven Cancer Registry area. In contrast to most previous studies, this study aimed to evaluate both surgically and non-surgically treated patients, to avoid the confounding effect of selective referral.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective cohort study included all patients diagnosed with oesophageal or gastric cardia cancer between 1995 and 2006. Results for the period 1995\u20131998 were compared with those for 1999\u20132006, after concentration of surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 1995 and 2006, 2212 patients were registered with the diagnosis, of whom 638 underwent resection. Before 1999, 73\u00b74 per cent of surgically treated patients underwent a resection in a low-volume hospital (fewer than 4 resections per year) and 23\u00b72 per cent were referred to an academic hospital. After concentration, 63\u00b72 per cent of surgically treated patients underwent resection in one of two regional high-volume centres (15\u201320 resections per year) and 13\u00b78 per cent were referred to an academic hospital. Three-year survival rates increased from 32\u00b70 to 45\u00b71 per cent for patients who had surgery (P = 0\u00b7004), and from 13\u00b71 to 17\u00b79 per cent for all included patients (P = 0\u00b7026). These improvements remained after adjustment for case mix or (neo)adjuvant treatments, and were similar for patients with squamous cell carcinoma or adenocarcinoma. However, adjustment for annual hospital volume attenuated this association for patients who had surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Concentration of oesophageal and gastric cardia cancer surgery was associated with improvements in long-term, population-based overall survival for surgically as well as non-surgically treated patients, apparently mediated by an increase in volume.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7493","type":"journal-article","created":{"date-parts":[[2011,4,20]],"date-time":"2011-04-20T17:44:18Z","timestamp":1303321458000},"page":"956-963","source":"Crossref","is-referenced-by-count":52,"title":["Impact of concentration of oesophageal and gastric cardia cancer surgery on long-term population-based survival"],"prefix":"10.1093","volume":"98","author":[{"given":"L V","family":"van de Poll-Franse","sequence":"first","affiliation":[{"name":"Comprehensive Cancer Centre South, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Centre of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V E P P","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Centre South, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J A","family":"Roukema","sequence":"additional","affiliation":[{"name":"Centre of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands"},{"name":"Department of Surgery, Elisabeth Hospital, Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J W W","family":"Coebergh","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Centre South, Catharina Hospital, Eindhoven, The Netherlands"},{"name":"Erasmus MC University Medical Centre, Department of Public Health, Rotterdam, 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":[[2011,4,20]]},"reference":[{"key":"2021070910501377200_bib1","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/S1091-255X(98)80011-5","article-title":"A hospital's annual rate of esophagectomy influences the operative mortality rate","volume":"2","author":"Patti","year":"1998","journal-title":"J Gastrointest 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