Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

A Survival Analysis of Gastric or Colorectal Cancer Patients Treated With Surgery: Comparison of Capital and a Non-capital City

  • Hong, Nam-Soo (Department of Preventive Medicine, Kyungpook National University School of Medicine) ;
  • Lee, Kyeong Soo (Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine) ;
  • Kam, Sin (Department of Preventive Medicine, Kyungpook National University School of Medicine) ;
  • Choi, Gyu Seog (Colorectal Cancer Center, Kyungpook National University Medical Center) ;
  • Kwon, Oh Kyoung (Gastric Cancer Center, Kyungpook National University Medical Center) ;
  • Ryu, Dong Hee (Daegu-Kyungpook Regional Cancer Center, Kyungpook National University Medical Center) ;
  • Kim, Sang Won (Department of Preventive Medicine and Public Health, Yeungnam University College of Medicine)
  • Received : 2017.03.17
  • Accepted : 2017.06.21
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The objective of the present study was to compare prognosis of patients with gastric or colorectal cancer according to places where they received surgeries. Methods: The cancer patients underwent surgeries in sampled hospitals located in Daegu were matched 1:1 to the patients who visited sampled hospitals in Seoul using propensity score method. After the occurrences of death were examined, Kaplan-Meier method was used for survival analysis and the log-rank test was performed to compare the survival curves. Results: A total of six out of 291 gastric cancer patients who had surgeries in Daegu died (2.1%) and ten deaths (3.4%) occurred from patients went Seoul hospitals. Out of 84 gastric cancer patients who had chemotherapy after surgeries in Daegu, 13 (15.5%) patients died while 18 (21.4%) deaths occurred among patients underwent surgeries in Seoul. Six deaths (6.9%) out of 87 colorectal cancer patients who had surgeries in Daegu were reported. Five patients (5.7%) died among the patients underwent surgeries in Seoul. Among the colorectal cancer patients with chemotherapy after surgeries, 13 patients (12.4%) who visited hospitals in Daegu and 14 (13.3%) patients who used medical centers in Seoul died. There were no significant differences according to places where patients used medical services. Conclusions: The result of this study is expected to be used as basic data for policy making to resolve centralization problem of cancer patients and to help patients to make rational choices in selection of medical centers.

Keywords

References

  1. Kim JH, Lee JH, Lee JH. Changes in healthcare utilizations of cancer patients since the launch of KTX. J Korean Soc Railw 2010;13(2):236-243 (Korean).
  2. Hong SO, Suh WS. Factors associated with utilization patterns of provincial patients discharged from general hospitals located in Seoul area. Korean J Health Educ Promot 2009;26(4): 117-127 (Korean).
  3. Lee SJ, Park JY. Changing trends in Daegu and Gyeongbuk-based patients' use of health facilities in Seoul. Health Policy Manag 2010;20(4):19-44 (Korean). https://doi.org/10.4332/KJHPA.2010.20.4.019
  4. Nam MH, Kim SS, Park IS, Kang SH, Kim WJ, Choi SH, et al. A study on utilization of non-residential areal in operation patient. J Korea Acad Ind Coop Soc 2010;11(6):2078-2087 (Korean). https://doi.org/10.5762/KAIS.2010.11.6.2078
  5. Park YH. Utilization patterns of other region inpatients in general hospitals located in Seoul area. Korean J Health Serv Manag 2011;5(3):63-76 (Korean). https://doi.org/10.12811/kshsm.2011.5.3.063
  6. Kim J, Lee J, Yoo W, Park S. Health impact assessment of high speed train (KTX) in Korea. Seoul: Korea Institute for Health and Social Affairs; 2008, p. 33-194 (Korean).
  7. Schwartz LM, Woloshin S, Birkmeyer JD. How do elderly patients decide where to go for major surgery? Telephone interview survey. BMJ 2005;331(7520):821. https://doi.org/10.1136/bmj.38614.449016.DE
  8. Do SR, Lee YH, Shin CW. Changes of patient's disease and characteristics of medical care use. Seoul: Korea Institute for Health and Social Affairs; 2004, p.10-166 (Korean).
  9. Chang DM. A study on utilization behavior of cancer patients. Korean J Public Health 1998;24(2):106-117 (Korean).
  10. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer 2011;14(2): 113-123. https://doi.org/10.1007/s10120-011-0042-4
  11. Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, et al. Synopsis on clinical practice guideline of gastric cancer in Korea: an evidence-based approach. Korean J Gastroenterol 2014;63 (2):66-81 (Korean). https://doi.org/10.4166/kjg.2014.63.2.66
  12. Korean Academy of Medical Science. Korean clinical practice guideline for colon and rectal cancer v. 1.0; 2012 [cited 2017 Aug 5]. Available from: http://www.kaim.or.kr/files/guide/%EC%86%8C%ED%99%94%EA%B8%B0_01.pdf (Korean).
  13. Hall WH, Jani AB, Ryu JK, Narayan S, Vijayakumar S. The impact of age and comorbidity on survival outcomes and treatment patterns in prostate cancer. Prostate Cancer Prostatic Dis 2005; 8(1):22-30. https://doi.org/10.1038/sj.pcan.4500772
  14. van Eeghen EE, Bakker SD, van Bochove A, Loffeld RJ. Impact of age and comorbidity on survival in colorectal cancer. J Gastrointest Oncol 2015;6(6):605-612.
  15. Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005;43(11): 1130-1139. https://doi.org/10.1097/01.mlr.0000182534.19832.83
  16. Klabunde CN, Harlan LC, Warren JL. Data sources for measuring comorbidity: a comparison of hospital records and medicare claims for cancer patients. Med Care 2006;44(10):921-928. https://doi.org/10.1097/01.mlr.0000223480.52713.b9
  17. Finlayson EV, Birkmeyer JD. Effects of hospital volume on life expectancy after selected cancer operations in older adults: a decision analysis. J Am Coll Surg 2003;196(3):410-417. https://doi.org/10.1016/S1072-7515(02)01753-2
  18. Raval MV, Bilimoria KY, Talamonti MS. Quality improvement for pancreatic cancer care: is regionalization a feasible and effective mechanism? Surg Oncol Clin N Am 2010;19(2):371-390. https://doi.org/10.1016/j.soc.2009.11.011
  19. Begg CB, Cramer LD, Hoskins WJ, Brennan MF. Impact of hospital volume on operative mortality for major cancer surgery. JAMA 1998;280(20):1747-1751. https://doi.org/10.1001/jama.280.20.1747
  20. Schrag D, Earle C, Xu F, Panageas KS, Yabroff KR, Bristow RE, et al. Associations between hospital and surgeon procedure volumes and patient outcomes after ovarian cancer resection. J Natl Cancer Inst 2006;98(3):163-171. https://doi.org/10.1093/jnci/djj018
  21. Yun YH, Kim YA, Min YH, Park S, Won YJ, Kim DY, et al. The influence of hospital volume and surgical treatment delay on long-term survival after cancer surgery. Ann Oncol 2012;23 (10):2731-2737. https://doi.org/10.1093/annonc/mds101
  22. National Cancer Center. Annual report of cancer statistics in Korea in 2015. Goyang: National Cancer Center; 2015, p. 19-194 (Korean).
  23. Dudley RA, Johansen KL, Brand R, Rennie DJ, Milstein A. Selective referral to high-volume hospitals: estimating potentially avoidable deaths. JAMA 2000;283(9):1159-1166. https://doi.org/10.1001/jama.283.9.1159
  24. Hollenbeck BK, Dunn RL, Miller DC, Daignault S, Taub DA, Wei JT. Volume-based referral for cancer surgery: informing the debate. J Clin Oncol 2007;25(1):91-96. https://doi.org/10.1200/JCO.2006.07.2454
  25. Han DS. A revisit to policy agenda concerned with the distortion of functional differentiation among health care providers. Health Policy Manag 2010;20(4):1-18 (Korean). https://doi.org/10.4332/KJHPA.2010.20.4.001
  26. Carr D, Goudas L, Lawrence D, Pirl W, Lau J, DeVine D, et al. Management of cancer symptoms: pain, depression, and fatigue. Evid Rep Technol Assess (Summ) 2002;61:368-374.
  27. Earle CC, Neville BA. Under use of necessary care among cancer survivors. Cancer 2004;101(8):1712-1719. https://doi.org/10.1002/cncr.20560
  28. Kim NS, Park EJ, Jeong JA, Hwang DK, Lee SH, Lee HY, et al. Analysis and improvement plan for rationalization of medical uses. Sejong: Korea Institute for Health and Social Affairs; 2015, p. 724 (Korean).
  29. Lipitz-Snyderman A, Bach PB. Overuse of health care services: when less is more … more or less. JAMA Intern Med 2013;173 (14):1277-1278. https://doi.org/10.1001/jamainternmed.2013.6181

Cited by

  1. The Effect of Residential Area and Hospital Bed Size on the Use of Hospital in Other Regions for Cancer Inpatients vol.43, pp.1, 2018, https://doi.org/10.21032/jhis.2018.43.1.18