Adherence to guidelines at the patient‐ and hospital‐levels is associated with improved overall survival in patients with gastric cancer. Issue 3 (26th April 2022)

• Record Type: Journal Article
• Authors: Kaslow, Sarah R.; Ma, Zhongyang; Hani, Leena; Prendergast, Katherine; Vitiello, Gerardo; Lee, Ann Y.; Berman, Russell S.; Goldberg, Judith D.; Correa‐Gallego, Camilo
• Is Part Of: Journal of surgical oncology. Volume 126:Issue 3(2022)
• Page Start: 479
• Page End: 489
• Publication Date: 2022-04-26
• Subjects: gastric cancer -- guideline adherence -- National Cancer Database -- treatment guidelines; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.26895
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract: Background and Objectives: Adherence to evidence‐based guidelines in gastric cancer is low. We aimed to evaluate adherence to National Comprehensive Cancer Network (NCCN) Guidelines for gastric cancer at both patient‐ and hospital‐levels and examine associations between guideline adherence and treatment outcomes, including overall survival (OS). Methods: We applied stage‐specific, annual NCCN Guidelines (2004–2015) to patients with gastric cancer treated with curative‐intent within the National Cancer Database and compared characteristics of patients who did and did not receive guideline‐adherent care. Hospitals were evaluated by guideline adherence rate. We identified associations with OS through multivariable Cox regression. Results: Of 37 659 patients included, 32% received NCCN Guideline‐adherent treatment. OS was significantly associated with both guideline adherence (51 months for patients receiving guideline‐adherent treatment vs. 22 for patients receiving nonadherent treatment, p < 0.001). Treatment at a hospital with higher adherence was associated with longer OS (21 months for patients treated at lowest adherence quartile hospitals vs. 37 months at highest adherence quartile hospitals, p < 0.001), regardless of type of treatment received. Conclusions: Guideline‐adherent treatment was strongly associated with longer median OS. Guideline adherence should be used as a benchmark for focused quality improvement for physicians taking care of patients with gastric cancer and institutions at large.