Implementation of cancer care guideline and quality of medical care

• Project/Area Number: 19K09111
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55010:General surgery and pediatric surgery-related
• Research Institution: Osaka General Medical Center
• Principal Investigator: 後藤 満一 地方独立行政法人大阪府立病院機構大阪急性期・総合医療センター(臨床研究支援センター), 大阪急性期・総合医療センター 名誉総長, 名誉総長 (50162160)
• Co-Investigator(Kenkyū-buntansha): 丸橋 繁 福島県立医科大学, 医学部, 教授 (20362725) ; 宮田 裕章 東京大学, 医学部附属病院, 特任教授 (70409704)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Project Status: Completed (Fiscal Year 2023)
• Budget Amount: ¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000); Fiscal Year 2021: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2019: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: NationalClinicalDatabase / 診療ガイドライン / アンケート調査 / Quality Indicator / 修練施設 / 手術関連死亡 / がん診療 / 国際共同研究 / がん診療ガイドラインの実施状況 / 医療の質 / リスク調整死亡率 / NCD

Outline of Research at the Start

本研究では、2012年から2年間にわたって実施した厚生労働科学研究費補助金 がん臨床研究事業「精度の高い臓器がん登録による診療ガイドラインや専門医育成への活用に関する研究」（後藤班）のアンケート調査内容から、食道癌・胃癌・大腸癌・肝癌・膵癌等の消化器癌に関して、ストラクチャーやプロセスが如何にアウトカムに影響を与えるかを全国レベルで明らかにする。

Outline of Annual Research Achievements

本研究では、2012年から2年間にわたって実施した厚生労働科学研究費補助金 がん臨床研究事業「精度の高い臓器がん登録による診療ガイドラインや専門医育成への活用に関する研究」(後藤班)の中で実施したアンケート調査結果をもとに、食道癌・胃癌・大腸癌・肝癌・膵癌等の消化器癌に関して、ストラクチャーやプロセスが如何にアウトカムに影響を与えるかを全国レベルで明らかにすることを目的とした。それぞれの癌に対する各種診療ガイドラインから推奨度の高いものを5-11項目選択し、これらの項目とともに、消化器外科関連学会の修練施設の区分、また、その専門医等を含む施設環境が、関連手術術式のリスク調整した手術関連死亡率にどのように影響を持つかを検討した。
それぞれの癌関連術式である食道切除再建術、胃切除術、胃全摘術、結腸右半切除術、低位前方切除術、肝切除術、膵頭十二指腸切除術において解析を進め、論文化を目指した。
また、医療の質の向上に関して米国ACS-NSQIPと共同研究を実施した。

Research Products

• [Int'l Joint Research] ACS-NSQIP(米国)
• [Int'l Joint Research] ACS-NSQIP(米国)
• [Int'l Joint Research] ACS-NSQIP(米国)
• [Int'l Joint Research] ACS-NSQIP(米国)
• [Int'l Joint Research] ACS-NSQIP(米国)
• [Journal Article] Impact of a board certification system and adherence to the clinical practice guidelines for gastric cancer on risk-adjusted surgical mortality after distal and total gastrectomy in Japan: a questionnaire survey of departments registered in the National Clinical Database (2023)
  • Author(s): Yamamoto Hiroyuki、Nashimoto Atsushi、Miyashiro Isao、Miyata Hiroaki、Toh Yasushi、Gotoh Mitsukazu、Kodera Yasuhiro、Kakeji Yoshihiro、Seto Yasuyuki
  • Journal Title: Surgery Today Volume: 54 Issue: 5 Pages: 459-470
  • DOI: 10.1007/s00595-023-02753-2
  • Peer Reviewed / Open Access
• [Journal Article] Achieving clinically optimal balance between accuracy and simplicity of a formula for manual use: Development of a simple formula for estimating liver graft weight with donor anthropometrics (2023)
  • Author(s): Ichihara Nao、Sato Naoya、Marubashi Shigeru、Miyata Hiroaki、Eguchi Susumu、Ohdan Hideki、Umeshita Koji、Gotoh Mitsukazu
  • Journal Title: PLOS ONE Volume: 18 Issue: 1 Pages: 1-1
  • DOI: 10.1371/journal.pone.0280569
  • Peer Reviewed / Open Access
• [Journal Article] Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan (2023)
  • Author(s): Yoshiki Kajiwara, Arata Takahashi, Hideki Ueno, Yoshihiro Kakeji, Hiroshi Hasegawa, Susumu Eguchi, Shigeru Marubashi, Mitsukazu Gotoh, Hiroyuki Konno, Hiroyuki Yamamoto, Hiroaki Miyata, Yasuyuki Seto, Yuko Kitagawa
  • Journal Title: Annals of Gastroenterological Surgery Volume: 7 Issue: 3 Pages: 367-406
  • DOI: 10.1002/ags3.12662
  • Peer Reviewed / Open Access
• [Journal Article] Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan (2023)
  • Author(s): Y. Kajiwara, A. Takahashi, H. Ueno, Y. Kakeji, H. Hasegawa, S. Eguchi, T. Goi, A. Saiura, A. Sasaki, S. Takiguchi, H. Takeuchi, C. Tanaka1, M. Hashimoto, N. Hiki, A. Horiguchi, S. Matsuda, T. Mizushima, S. Marubashi, M. Gotoh, H. Konno, H. Yamamoto, H. Miyata, Y. Seto, Y. Kitagawa
  • Journal Title: Ann Gastroenterol Surg Volume: ‐
  • Peer Reviewed
• [Journal Article] Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients (2022)
  • Author(s): Kumamaru Hiraku、Kakeji Yoshihiro、Fushimi Kiyohide、Ishikawa Koichi Benjamin、Yamamoto Hiroyuki、Hashimoto Hideki、Ono Minoru、Iwanaka Tadashi、Marubashi Shigeru、Gotoh Mitsukazu、Seto Yasuyuki、Kitagawa Yuko、Miyata Hiroaki
  • Journal Title: Surgery Today Volume: 52 Issue: 12 Pages: 1766-1774
  • DOI: 10.1007/s00595-022-02523-6
  • Peer Reviewed / Open Access
• [Journal Article] Cost of Postoperative Complications in 15,187 Patients Undergoing Lower Anterior Resection for Rectal Cancer: A Nationwide Registry Study (2022)
  • Author(s): Hiraku Kumamaru, Yoshihiro Kakeji, Kiyohide Fushimi, Koichi Benjamin Ishikawa, Hiroyuki Yamamoto, Hideki Hashimoto, Minoru Ono, Tadashi Iwanaka, Shigeru Marubashi, Mitsukazu Gotoh, Yasuyuki Seto, Yuko Kitagawa, Hiroaki Miyata
  • Journal Title: Surg Today Volume: -
  • Peer Reviewed / Open Access
• [Journal Article] Development of gastroenterological surgery over the last decade in Japan: analysis of the National Clinical Database (2021)
  • Author(s): Kakeji Yoshihiro、Yamamoto Hiroyuki、Ueno Hideki、Eguchi Susumu、Endo Itaru、Sasaki Akira、Takiguchi Shuji、Takeuchi Hiroya、Hashimoto Masaji、Horiguchi Akihiko、Masaki Tadahiko、Marubashi Shigeru、Yoshida Kazuhiro、Miyata Hiroaki、Konno Hiroyuki、Gotoh Mitsukazu、Kitagawa Yuko、Mori Masaki、Seto Yasuyuki
  • Journal Title: Surgery Today Volume: 51 Issue: 2 Pages: 187-193
  • DOI: 10.1007/s00595-020-02075-7
  • Peer Reviewed / Open Access
• [Journal Article] Surgical outcomes in gastroenterological surgery in Japan: Report of the National Clinical Database 2011-2019 (2021)
  • Author(s): Marubashi S, Takahashi A, Kakeji Y, Hasegawa H, Ueno H, Eguchi S, Endo I, Goi T, Saiura A, Sasaki A, Takiguchi S, Takeuchi H, Tanaka C, Hashimoto M, Hiki N, Horiguchi A, Masaki T, Yoshida K, Gotoh M, Konno H, Yamamoto H, Miyata H, Seto Y, Kitagawa Y; National Clinical Database
  • Journal Title: Annals of Gastroenterological Surgery Volume: 5 Issue: 5 Pages: 639-658
  • DOI: 10.1002/ags3.12462
  • NAID: 120007148933
  • Peer Reviewed / Open Access
• [Journal Article] Estimates of the effects of centralization policy for surgery in Japan: does centralization affect the quality of healthcare for esophagectomies? (2021)
  • Author(s): Takahashi Arata、Yamamoto Hiroyuki、Kakeji Yoshihiro、Marubashi Shigeru、Gotoh Mitsukazu、Seto Yasuyuki、Miyata Hiroaki
  • Journal Title: Surgery Today Volume: 51 Issue: 6 Pages: 1010-1019
  • DOI: 10.1007/s00595-021-02245-1
  • Peer Reviewed / Open Access
• [Journal Article] Validation of data quality in a nationwide gastroenterological surgical database: The National Clinical Database site‐visit and remote audits, 2016‐2018 (2021)
  • Author(s): Hasegawa Hiroshi、Takahashi Arata、Kanaji Shingo、Kakeji Yoshihiro、Marubashi Shigeru、Konno Hiroyuki、Gotoh Mitsukazu、Miyata Hiroaki、Kitagawa Yuko、Seto Yasuyuki
  • Journal Title: Annals of Gastroenterological Surgery Volume: 5 Issue: 3 Pages: 296-303
  • DOI: 10.1002/ags3.12419
  • NAID: 120007097044
  • Peer Reviewed / Open Access
• [Journal Article] Impact of board certification system and adherence to the clinical practice guidelines for liver cancer on post‐hepatectomy risk‐adjusted mortality rate in Japan: A questionnaire survey of departments registered with the National Clinical Database (2021)
  • Author(s): Arita Junichi、Yamamoto Hiroyuki、Kokudo Takashi、Hasegawa Kiyoshi、Miyata Hiroaki、Toh Yasushi、Gotoh Mitsukazu、Kokudo Norihiro、Kakeji Yoshihiro、Seto Yasuyuki
  • Journal Title: Journal of Hepato-Biliary-Pancreatic Sciences Volume: 28 Issue: 10 Pages: 801-811
  • DOI: 10.1002/jhbp.1000
  • Peer Reviewed / Open Access
• [Journal Article] Validation study of the ACS NSQIP surgical risk calculator for two procedures in Japan (2021)
  • Author(s): Ma Meixi、Liu Yaoming、Gotoh Mitsukazu、Takahashi Arata、Marubashi Shigeru、Seto Yasuyuki、Endo Itaru、Ko Clifford Y.、Cohen Mark E.
  • Journal Title: The American Journal of Surgery Volume: 222 Issue: 5 Pages: 877-881
  • DOI: 10.1016/j.amjsurg.2021.06.008
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Geriatric Risk Prediction Models for Major Gastroenterological Surgery using the National Clinical Database in Japan (2020)
  • Author(s): Kofunato Yasuhide、Takahashi Arata、Gotoh Mitsukazu、Kakeji Yoshihiro、Seto Yasuyuki、Konno Hiroyuki、Kumamaru Hiraku、Miyata Hiroaki、Marubashi Shigeru
  • Journal Title: Annals of Surgery Volume: Publish Ahead of Print Issue: 6 Pages: 1112-1120
  • DOI: 10.1097/sla.0000000000004308
  • Peer Reviewed / Open Access
• [Journal Article] Surgical outcomes in gastroenterological surgery in Japan. Report of National Clinical database 2011-2018. (2020)
  • Author(s): Kakeji Y, Takahashi A, Hasegawa H, Ueno H, Eguchi S, Endo I, Sasaki A, Takiguchi S, Takeuchi H, Hashimoto M, Horiguchi A, Masaki T, Marubashi S, Yoshida K, Gotoh M, Konno H, Yamamoto H, Miyata H, Seto Y, Kitagawa Y
  • Journal Title: Ann Gastroenterol Surg Volume: 4(3) Issue: 3 Pages: 250-274
  • DOI: 10.1002/ags3.12324
  • Peer Reviewed / Open Access
• [Journal Article] Impact of a board certification system and implementation of clinical practice guidelines for pancreatic cancer on mortality of pancreaticoduodenectomy (2020)
  • Author(s): Mizuma Masamichi、Yamamoto Hiroyuki、Miyata Hiroaki、Gotoh Mitsukazu、Unno Michiaki、Shimosegawa Tooru、Toh Yasushi、Kakeji Yoshihiro、Seto Yasuyuki
  • Journal Title: Surgery Today Volume: - Issue: 10 Pages: 1297-1307
  • DOI: 10.1007/s00595-020-02017-3
  • Peer Reviewed / Open Access
• [Journal Article] Impact of adherence to board-certified surgeon systems and clinical practice guidelines on colon cancer surgical outcomes in Japan: A questionnaire survey of the National Clinical Database (2020)
  • Author(s): Kobayashi Hirotoshi、Yamamoto Hiroyuki、Miyata Hiroaki、Gotoh Mitsukazu、Kotake Kenjiro、Sugihara Kenichi、Toh Yasushi、Kakeji Yoshihiro、Seto Yasuyuki
  • Journal Title: Annals of Gastroenterological Surgery Volume: - Issue: 3 Pages: 283-293
  • DOI: 10.1002/ags3.12327
  • Peer Reviewed / Open Access
• [Journal Article] Significance of the board-certified surgeon systems and clinical practice guideline adherence to surgical treatment of esophageal cancer in Japan: a questionnaire survey of departments registered in the National Clinical Database (2019)
  • Author(s): Toh Yasushi、Yamamoto Hiroyuki、Miyata Hiroaki、Gotoh Mitsukazu、Watanabe Masayuki、Matsubara Hisahiro、Kakeji Yoshihiro、Seto Yasuyuki
  • Journal Title: Esophagus Volume: － Issue: 4 Pages: 362-370
  • DOI: 10.1007/s10388-019-00672-1
  • Peer Reviewed / Open Access
• [Presentation] パネルディスカッション4：肝がん診療ガイドラインと専門医制度が肝細胞癌の外科診療に与える影響：NCDデータと施設アンケートを用いたQuality indicator による診療の質評価 (2021)
  • Author(s): 有田淳一、山本博之、國土貴嗣、藤 也寸志、瀬戸泰之、宮田裕章、長谷川潔、後藤満一
  • Organizer: 第121回日本外科学会総会定期学術集会