AI Article Synopsis
- Adherence to National Comprehensive Cancer Network (NCCN) Guidelines for gastric cancer treatment is low, with only 32% of patients receiving recommended care from 2004-2015.
- Patients who received guideline-adherent treatment had a significantly longer overall survival (OS) of 51 months compared to 22 months for those who did not adhere to the guidelines.
- Treatment at hospitals with higher rates of adherence to the guidelines also correlated with better OS, highlighting the importance of both physician and institutional compliance with evidence-based practices in improving patient outcomes.
Article 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.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339461 | PMC |
| http://dx.doi.org/10.1002/jso.26895 | DOI Listing |
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