PMID- 27988444
OWN - NLM
STAT- MEDLINE
DCOM- 20170707
LR  - 20181202
IS  - 1879-0852 (Electronic)
IS  - 0959-8049 (Linking)
VI  - 71
DP  - 2017 Jan
TI  - Regional and inter-hospital differences in the utilisation of liver surgery for 
      patients with synchronous colorectal liver metastases in the Netherlands.
PG  - 109-116
LID - S0959-8049(16)32532-1 [pii]
LID - 10.1016/j.ejca.2016.10.026 [doi]
AB  - BACKGROUND: The objective of this study was to map referral patterns in patients 
      with synchronous colorectal liver metastases (SCLM) and to investigate if type, 
      volume and location of the hospital of diagnosis are associated with whether or 
      not patients underwent liver resection. METHODS: This population-based study 
      includes all patients diagnosed with SCLM between 2008 and 2012, based on the 
      Netherlands Cancer Registry. To study inter-hospital variation, the proportion of 
      patients undergoing liver surgery was calculated per hospital of diagnosis. 
      Multivariable multilevel logistic regression analysis was used to investigate the 
      association between hospital characteristics and liver resection. RESULTS: Of 
      10,520 patients with SCLM, 12% (n = 1259) underwent liver surgery. Of these 
      patients, 58% (n = 733) were referred to another hospital to undergo liver 
      surgery. In 53% of the patients (n = 647), liver resection was performed in a 
      university hospital, in 39% (n = 482) in a dedicated liver centre and in 8% 
      (n = 102) in a general hospital. There was a large inter-hospital variation in 
      the proportion of patients undergoing liver resection (2-26%). In a multilevel 
      logistic regression model, the odds of undergoing liver surgery were higher when 
      patients were diagnosed in hospitals where liver surgery was performed compared 
      with the general hospitals (dedicated liver centre: odds ratio 1.36 [95% 
      confidence intervals 1.08-1.70], university hospital: odds ratio 1.69 [95% 
      confidence intervals 1.22-2.34]). CONCLUSION: There is a large inter-hospital and 
      inter-regional variation in the utilisation of liver resection. Patients 
      diagnosed with SCLM in expert centres had a higher chance of undergoing liver 
      resection.
CI  - Copyright (c) 2016 Elsevier Ltd. All rights reserved.
FAU - 't Lam-Boer, J
AU  - 't Lam-Boer J
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The 
      Netherlands. Electronic address: Jorine.tLam-Boer@radboudumc.nl.
FAU - van der Stok, E P
AU  - van der Stok EP
AD  - Division of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The 
      Netherlands.
FAU - Huiskens, J
AU  - Huiskens J
AD  - Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
FAU - Verhoeven, R H A
AU  - Verhoeven RH
AD  - Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
FAU - Punt, C J A
AU  - Punt CJ
AD  - Department of Medical Oncology, Academic Medical Center, Amsterdam, The 
      Netherlands.
FAU - Elferink, M A G
AU  - Elferink MA
AD  - Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
FAU - de Wilt, J H
AU  - de Wilt JH
AD  - Department of Surgery, Radboud University Medical Center, Nijmegen, The 
      Netherlands.
FAU - Verhoef, C
AU  - Verhoef C
AD  - Division of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The 
      Netherlands.
CN  - CAIRO5/CHARISMA Group
LA  - eng
PT  - Journal Article
DEP - 20161216
PL  - England
TA  - Eur J Cancer
JT  - European journal of cancer (Oxford, England : 1990)
JID - 9005373
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/*pathology
MH  - Female
MH  - Hepatectomy/*statistics & numerical data
MH  - Hospitals/*statistics & numerical data
MH  - Humans
MH  - Liver Neoplasms/*secondary/*surgery
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Netherlands
MH  - Practice Patterns, Physicians'/*statistics & numerical data
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Inter-hospital differences
OT  - Liver metastases
OT  - Liver surgery
OT  - Stage IV
FIR - Dejong, C H C
IR  - Dejong CH
IRAD- Maastricht University Medical Center, Maastricht, The Netherlands.
FIR - Grunhagen, D
IR  - Grunhagen D
IRAD- Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
FIR - van Gulik, T M
IR  - van Gulik TM
IRAD- Academic Medical Center, Amsterdam, The Netherlands.
FIR - de Jong, K P
IR  - de Jong KP
IRAD- University Medical Center Groningen, University of Groningen, Groningen, The 
      Netherlands.
FIR - Kazemier, G
IR  - Kazemier G
IRAD- VU University Medical Centre, Amsterdam, The Netherlands.
FIR - Molenaar, I Q
IR  - Molenaar IQ
IRAD- University Medical Center Utrecht, Utrecht, The Netherlands.
FIR - Ruers, T M
IR  - Ruers TM
IRAD- Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
EDAT- 2016/12/19 06:00
MHDA- 2017/07/08 06:00
CRDT- 2016/12/19 06:00
PHST- 2016/04/19 00:00 [received]
PHST- 2016/10/12 00:00 [revised]
PHST- 2016/10/21 00:00 [accepted]
PHST- 2016/12/19 06:00 [pubmed]
PHST- 2017/07/08 06:00 [medline]
PHST- 2016/12/19 06:00 [entrez]
AID - S0959-8049(16)32532-1 [pii]
AID - 10.1016/j.ejca.2016.10.026 [doi]
PST - ppublish
SO  - Eur J Cancer. 2017 Jan;71:109-116. doi: 10.1016/j.ejca.2016.10.026. Epub 2016 Dec 
      16.