Dataset Information

Multi-institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer.

ABSTRACT:

Background

Insufficient data are available on the prognostic significance of complications after resection of gastric cancer. Therefore, we aimed to assess this gap in our knowledge by studying patients with resectable gastric cancer.

Methods

A multi-institutional retrospective database comprising clinical information of 3575 patients who received resection of gastric cancer from 2010 to 2014 at nine institutions. Grades 2 or greater complications of the Clavien-Dindo classification were judged as clinically relevant postoperative complications, and their associations with postoperative survival were assessed. We assessed the effect of complications on times of initiation and continuation of postoperative adjuvant chemotherapy by S-1.

Results

A total of 2954 patients were included in the analysis. Clinically relevant postoperative complications occurred in 664 (23%) patients. Patients' recurrence-free survival rate incrementally decreased as the grade of complications became greater. Patients with abdominal complications (eg, leakage of pancreatic fluids, intra-abdominal abscess, and anastomotic leakage) and those with nonabdominal complications (eg, pneumonia) experienced worse recurrence-free survival compared to those without complications. Patients who had complications were generally at greater risk of disease recurrence, except for those who underwent laparoscopic surgery and those with pathological stage I. Delayed initiation and shorter continuation of adjuvant S-1 chemotherapy was experienced by patients with postoperative complications.

Conclusions

Postoperative complications adversely affected the prognosis in patients with resectable gastric cancer.

SUBMITTER: Kanda M

PROVIDER: S-EPMC6718595 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Multi-institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer.

Kanda Mitsuro M Ito Seiji S Mochizuki Yoshinari Y Teramoto Hitoshi H Ishigure Kiyoshi K Murai Toshifumi T Asada Takahiro T Ishiyama Akiharu A Matsushita Hidenobu H Tanaka Chie C Kobayashi Daisuke D Fujiwara Michitaka M Murotani Kenta K Kodera Yasuhiro Y

Cancer medicine 20190729 11

<h4>Background</h4>Insufficient data are available on the prognostic significance of complications after resection of gastric cancer. Therefore, we aimed to assess this gap in our knowledge by studying patients with resectable gastric cancer.<h4>Methods</h4>A multi-institutional retrospective database comprising clinical information of 3575 patients who received resection of gastric cancer from 2010 to 2014 at nine institutions. Grades 2 or greater complications of the Clavien-Dindo classificati ...[more]

PMID: 31353821

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Project description:BACKGROUND:High-quality randomized controlled trials have demonstrated the benefit of radiotherapy (RT) in patients with radical resected gastric cancer (GC), however, utilization rates of postoperative RT remain remarkably low. Patterns, incidences, and time of recurrence provide biological bases for clinical monitoring of GC patients and guiding potential complementary therapies. Thus, the aim of this study is to understand the location of locoregional recurrence which may allow individualized RT strategies and minimize radiation-related toxic effects. METHODS:A relatively large sample of GC patients in a single institution who had undergone curative D2 resection was retrospectively reviewed and the relevant recurrence patterns were illustrated. Independent recurrence-related risk factors were analyzed by logistic regression analysis. New logistic regression models were further developed to predict the probability of recurrence. RESULTS:Overall, among 776 GC patients who had continuous and complete follow-up data, 300 cases relapsed after curative resection. Lymphovascular invasion, lymph node metastases, and tumor stage were indicators for early recurrence. Peritoneal, regional, local, and distant recurrence initially occurred in 51 (6.6%), 151 (19.4%), 56 (7.2%), and 164 (21.1%) patients, respectively. Among patients with regional recurrence, the most common sites were lymph node stations 16a2, 8, 12, 16b1, and 9. Remnant stomach recurrence was not so prominent that it seemed reasonable to be excluded from an irradiation field for patients with negative surgical/pathologic margins. CONCLUSIONS:For GC patients who underwent radical D2 resection, distant and regional recurrences were still common. Besides, optimizing regional control of lymph nodes outside the D2 dissected area was crucial for rational design of the RT field. Furthermore, the new logistic regression models might act as useful tools to evaluate recurrence risk and determine which patients should receive postoperative chemoradiotherapy.

Dataset Information

Multi-institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer.

Background

Methods

Results

Conclusions

Publications

Multi-institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer.

Similar Datasets

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