Surgical resection of gastric cancer in New York City 2000

Abstract

4046 Background: A New York City National Cancer Institute supported Comprehensive Cancer Center (CCC) has a high hospital volume providing surgical resection of gastric cancer. The demographic differences between the CCC and other Community University (C/U) hospitals in NYC are not known. The objective of this study was to examine the potential impact of demographic differences between referral centers (CCC) and C/U hospitals in regards to outcomes after gastric cancer resection. Methods: Using the Statewide Planning and Research Cooperative System (SPARCS) database for NYC 2000, descriptive statistic(s) on the prevalence of gastric cancer and surgical procedures was observed. Chi square test of significance was performed to measure the relationships between race/ethnicity, insurance status, types of surgical resection and access to C/U versus CCC care. Results: There were 1153 admissions in 51 NYC hospitals for gastric cancer and a total of 420 patients were resected, 312 resections were done in 50 C/U hospitals, the highest C/U doing 25 cases, while 108 cases were performed by 5 surgeons in one CCC. The median length of stay was 10 days in the CCC and 11 in the C/U. The in-hospital death rate was 1.9 % for the CCC compared with 5.4% in the C/U. There were differences between the two populations when considering the areas listed in the table below: Conclusions: The CCC had a lower mortality, shorter length of stay, more Medicare, more proximal lesions and less Medicaid and black patients. These improved outcomes for the CCC may be related to high volume, quality of care, location of tumors or demographic differences. No significant financial relationships to disclose.