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Validation of data quality in the Swedish National Register for Oesophageal and Gastric Cancer
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
Karolinska Univ Hosp, Ctr Digest Dis, Div Surg, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
Skane Univ Hosp, Dept Surg, Lund, Sweden..
Karolinska Univ Hosp, Ctr Digest Dis, Div Surg, Stockholm, Sweden.;Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
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2016 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 103, no 10, p. 1326-1335Article in journal (Refereed) Published
Abstract [en]

Background The Swedish National Register for Oesophageal and Gastric Cancer (NREV) was launched in 2006. Data are reported at diagnosis (diagnostic survey), at the time of surgery (surgical survey) and at first outpatient follow-up (follow-up survey). The aim of this study was to evaluate data originating from NREV in terms of comparability, completeness, accuracy and timeliness. Methods Coding routines were compared with international standards and completeness was evaluated by means of a 5-year (2009-2013) comparison with mandatory national registers. Validity was tested by comparison with reabstracted data from source medical records in 400 patients chosen randomly with stratification for hospital size and catchment area population. Timeliness of registration was described. Results Coding routines followed national and international guidelines. Compared with the Swedish Cancer Registry from 2009 to 2013, 6069 (95.5 per cent) of 6354 patients were registered in NREV at the time of data extraction. Of 60 variables investigated, 10966 of 12035 original entries were correct in the reabstraction, resulting in an exact agreement of 91.1 per cent in the register. There were 782 (6.5 per cent) incorrect and 287 (2.4 per cent) missing entries. Median time to registration was 3.9, 3.4 and 4.1 months for diagnostic, surgical and follow-up surveys respectively. Conclusion NREV has reached a position with good coverage of those with the relevant diagnoses, and contains comparable and valid data. Quality data on each variable are available. Timeliness is an area with potential for improvement.

Place, publisher, year, edition, pages
2016. Vol. 103, no 10, p. 1326-1335
National Category
Gastroenterology and Hepatology Surgery
Identifiers
URN: urn:nbn:se:uu:diva-305486DOI: 10.1002/bjs.10234ISI: 000383289500012PubMedID: 27467590OAI: oai:DiVA.org:uu-305486DiVA, id: diva2:1038509
Available from: 2016-10-18 Created: 2016-10-18 Last updated: 2018-03-20Bibliographically approved
In thesis
1. Esophageal- and Gastroesophageal Junctional Cancer: Aspects on Staging, Treatment and Results
Open this publication in new window or tab >>Esophageal- and Gastroesophageal Junctional Cancer: Aspects on Staging, Treatment and Results
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Esophageal- and gastroesophageal junctional (GEJ) cancer is the sixth cause of cancer-related death worldwide. Some improvements in care are attributed to nationwide disease-specific registries, preoperative staging and increased understanding of mechanisms affecting patient selection. Surgery, however, is a cornerstone for treatment where minimally invasive surgery and increased understanding of perioperative physiology may be beneficial. The aims of this thesis were to validate the Swedish national registry for esophageal and gastric cancer (NREV) and to explore mechanisms in patient selection, perioperative physiology, treatment-related outcomes and staging.

A validation study with re-abstracted data on 400 patients determined NREV comparable to other similar registries and to have a completeness of 95.5 %. Overall accuracy was 91.1 % throughout the registry and timeliness to reporting was adequate.

In a cohort of 4112 patients from NREV, high education level was associated with an increased probability of being allocated to curative treatment, as was the presence of a multidisciplinary treatment conference. High education level was associated with improved survival.

By measuring intramucosal pH (pHi) in 32 patients, to describe perfusion in the gastric conduit during esophagectomy, a reduction in perfusion was seen at all surgical steps altering vascular supply to the conduit but foremost after gastric tube construction by linear stapling. Patients with low pHi on the first postoperative day were more prone to anastomotic insufficiency.

In 116 patients undergoing esophagectomy (65 open and 51 minimally invasive), a retrospective cohort study regarding surgical oncological results and postoperative complications was conducted. Lymph node yield was increased, peroperative blood loss and in-hospital stay were reduced with minimally invasive esophagectomy. Postoperative complications were unaffected by surgical approach. 

In a prospective study of nineteen patients, whole-body integrated PET/MRI was compared to PET/CT in preoperative staging. PET/MRI was safe and feasible. Accuracy and correlations between modalities were good regarding tumor characteristics and N- and M-staging. In T-staging there were discrepancies indicating differences between modalities.

The thesis presents data on the quality of NREV for future research and elaborates on patient selection, staging, perioperative physiology and treatment-related outcomes for patients with esophageal- and GEJ cancer.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 95
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1447
Keywords
Esophageal cancer, Education level, Tonometry, Lymphadenectomy, PET/MRI
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:uu:diva-346690 (URN)978-91-513-0286-7 (ISBN)
Public defence
2018-05-11, Grönwallsalen, ingång 70bv, Akademiska sjukhuset, Uppsala, 09:00 (English)
Opponent
Supervisors
Available from: 2018-04-16 Created: 2018-03-20 Last updated: 2018-06-08

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