Clinical epidemiology of the endoscopic, laparoscopic, and surgical resection of malignant gastric tumors in Japan, 2014-2021: a retrospective study using open data from a national claims database.

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gastric Cancer Pub Date : 2024-09-28 DOI:10.1007/s10120-024-01553-y
Akahito Sako, Tomoyuki Yada, Keiichi Fujiya, Ryo Nakashima, Kensuke Yoshimura, Hidekatsu Yanai, Naomi Uemura
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引用次数: 0

Abstract

Background: Gastric cancer is a common malignancy with a high incidence in East Asia. Gastric resection ranges from endoscopic resection to open total gastrectomy. However, nationwide data are lacking.

Methods: This observational study analyzed data from the publicly accessible National Database of Health Insurance Claims and Specific Health Checkups, which includes most national health insurance claims data in Japan. Trends in the types of resection performed for malignant gastric tumors between 2014 and 2021, patients' age and sex distributions, and regional disparities were investigated.

Results: The annual number of resections was highest in 2015 (109,000) and lowest in 2020 (90,000) after the COVID-19 pandemic. The proportion of endoscopic resections increased from 47% in 2014 to 57% in 2021 while that of total gastrectomies decreased from 17 to 10%. In 2021, 70% of patients who underwent resection were men. That year, 83.8% of all patients who underwent any type of gastric resection and 87.1% of those who underwent endoscopic submucosal dissection were aged ≥ 65 years. The annual incidence of gastric resection per million population was highest in Tottori (n = 1236) and lowest in Okinawa (n = 251). The proportion of endoscopic resections was highest in Miyagi (66%) and lowest in Aichi (45%) and that of open surgery was highest in Aomori (36%) and lowest in Wakayama (5%).

Conclusions: Gastric malignancy is increasingly treated by endoscopic submucosal dissection rather than open total gastrectomy. However, regional disparities remain in resection type. Standardization of treatment and a more even distribution of specialists are needed.

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2014-2021年日本恶性胃肿瘤内镜、腹腔镜和手术切除的临床流行病学:一项利用全国索赔数据库公开数据进行的回顾性研究。
背景:胃癌是一种常见的恶性肿瘤,在东亚发病率很高。胃切除术包括内镜下切除术和开腹全胃切除术。然而,目前尚缺乏全国性的数据:这项观察性研究分析了可公开访问的 "全国健康保险索赔和特定健康检查数据库 "中的数据,该数据库包括日本大多数全国健康保险索赔数据。研究调查了 2014 年至 2021 年间胃恶性肿瘤切除术的类型趋势、患者的年龄和性别分布以及地区差异:结果:在 COVID-19 大流行之后,每年的切除数量在 2015 年最高(109,000 例),在 2020 年最低(90,000 例)。内镜下切除术的比例从2014年的47%增至2021年的57%,而全胃切除术的比例则从17%降至10%。2021年,70%的切除患者为男性。当年,83.8%接受任何类型胃切除术的患者和87.1%接受内镜黏膜下剥离术的患者年龄≥65岁。每百万人口中,鸟取县的胃切除术年发生率最高(n = 1236),冲绳县最低(n = 251)。宫城县内镜切除比例最高(66%),爱知县最低(45%);青森县开放手术比例最高(36%),和歌山县最低(5%):胃恶性肿瘤越来越多地采用内镜下粘膜下剥离术治疗,而不是开腹全胃切除术。结论:越来越多的胃恶性肿瘤采用内镜下粘膜下剥离术治疗,而不是开腹全胃切除术。需要实现治疗的标准化和专家分布的更均衡。
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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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