Gastric cancer: no differences among hospitals

Patients with gastric cancer have the same chances of survival in both large and small hospitals in the northeast of the Netherlands. This is what medical oncologist Ester Siemerink of University Medical Center Groningen says. She will be awarded a PhD for her research by the University of Groningen on Monday 13 December 2010.

Worldwide, gastric cancer is the fifth most common form of cancer, but in second place when it comes to the number of cancer-related deaths. Ester Siemerink investigated which hospital factors could determine the long-term survival chances of gastric cancer patients. Her most important conclusion is that there are no differences in death rates in hospitals in the northeast of the Netherlands when it comes to size, training status or referral behaviour. The region has fifteen training hospitals, eight non-training hospitals and the academic hospital UMCG.

Known risk factors for gastric cancer include bacterial infection (Heliobacter pylori), smoking and eating a lot of salt. It was already known that of the 2,000 Dutch cases per year, a relatively high number come from the lower socioeconomic groups. Ester Siemerink discovered that they also have increased chances of dying.

Immigrants

Siemerink also investigated whether non-Western immigrants have a greater chance of dying of gastric cancer. Her hypothesis was that for various reasons (cultural, religious, communication), this group’s access to care institutions is less good and that they thus only are treated in an already advanced stage of the disease. Surprisingly she discovered that the survival chances of this group are relatively good, which is not immediately possible to explain.

Older patients

A special chapter in Siemerink’s thesis is devoted to the survival chances after an operation of gastric cancer patients who are over eighty. Her conclusion is that the chances of dying as a result of the operation are very high – in the group aged 85 and older, one in three patients dies within two months of the operation. According to Siemerink, a better selection process could prevent unnecessary deaths. Patients who as a result are not considered suitable for an operation must then qualify for better palliative care, and that is an area where much more research is needed.

Curriculum vitae

Ester Siemerink (Oldenzaal, 1976) studied medicine in Rotterdam and trained to be an internist-oncologist in Groningen. She conducted her PhD research in the department of Medical Oncology of the UMCG. Her thesis is entitled ‘Gastric cancer: patient and treatment characteristics in relation to outcome’. Siemerink has worked since 2008 as a medical oncologist for the Medical Oncology department of the UMCG.

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