Long-term impact of postoperative pneumonia after curative gastrectomy for elderly gastric cancer patients

Abstract Background: Several studies have demonstrated that diverse systemic inflammatory-based prognostic parameters predict poor prognosis in patients with gastric cancer. However, few studies focused on the relationships between postoperative complications and systemic inflammatory-based prognostic parameters after curative gastrectomy. We investigated the relationships between postoperative complications and these parameters to identify parameter-specific postoperative complications, and assessed the clinical utility of the parameters as predictors of postoperative complications in stage I–III gastric cancer patients.Methods: We retrospectively reviewed 300 patients who underwent curative gastrectomy for stage I–III gastric cancer. A postoperative complication sensitive to the systemic inflammatory-based prognostic parameters was identified using a receiver operating characteristic curve, and we evaluated the relationships between the identified postoperative complication and other clinical factors.Results: In total, 101 patients (33.7%) had postoperative Clavien–Dindo grade II–IV complications, namely anastomotic complications, such as leak, stenosis, or hemorrhage (35 patients, 11.7%); pancreatic fistula (16 patients, 5.3%); and pneumonia (14 patients, 4.7%). Postoperative pneumonia had the most sensitive relationship to five systemic inflammatory-based prognostic parameters, and was associated with poor prognosis in stage I–III gastric cancer patients after curative gastrectomy. Multivariate analysis revealed that preoperative neutrophil-to-lymphocyte ratio (odds ratio: 5.228, 95% confidence interval: 1.269–21.541; P=0.022) was an independent predictor of postoperative pneumonia.Conclusions: Preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of postoperative pneumonia in stage I–III gastric cancer patients after curative gastrectomy.

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Preoperative Neutrophil-to-Lymphocyte Ratio may Predict Postoperative Pneumonia in Stage I–III Gastric Cancer Patients After Curative Gastrectomy: A Retrospective Study

World Journal of Surgery ◽

10.1007/s00268-021-06264-4 ◽

2021 ◽

Author(s):

Mikito Mori ◽

Kiyohiko Shuto ◽

Atsushi Hirano ◽

Kazuo Narushima ◽

Chihiro Kosugi ◽

...

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

Cancer Patients ◽

Neutrophil To Lymphocyte Ratio ◽

Stage I ◽

Postoperative Pneumonia ◽

Curative Gastrectomy ◽

Lymphocyte Ratio ◽

Gastric Cancer Patients

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Weekday of Surgery Affects Postoperative Complications and Long-Term Survival of Chinese Gastric Cancer Patients after Curative Gastrectomy

BioMed Research International ◽

10.1155/2017/5090534 ◽

2017 ◽

Vol 2017 ◽

pp. 1-11

Author(s):

Rong Li ◽

Ai-min Leng ◽

Ting Liu ◽

Yan-wu Zhou ◽

Jun-xian Zeng ◽

...

Keyword(s):

Gastric Cancer ◽

Postoperative Complications ◽

Cancer Patients ◽

Rank Test ◽

Curative Gastrectomy ◽

Term Survival ◽

Long Term Survival ◽

Gastric Cancer Patients

Many factors have been reported to affect the long-term survival of gastric carcinoma patients after gastrectomy; the present study took the first attempt to find out the potential role of weekday carried out surgery in the postoperative prognosis of gastric cancer patients. 463 gastric cancer patients have been followed up successfully. Pearsonχ2test was used for univariate analyses. Survival curves were constructed by using Kaplan-Meier method and evaluated by using the log-rank test. The Cox proportional hazard regression model was used to find out the risk factors, and subgroup analysis was conducted to rule out confounding factors. We found that the patients who underwent gastrectomy on the later weekday (Wednesday–Friday) more easily suffered from a higher postoperative morbidity. Weekday of surgery was one of the independent indicators for the prognosis of patients after gastric cancer surgery. However, the role of weekday of surgery was significantly weakened in the complications group. In conclusion, surgery performed in the later weekday was more likely to lead to increased postoperative complications and an unfavorable role in prognosis of Chinese gastric cancer patients after curative gastrectomy.

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Preoperative skeletal muscle index and visceral-to-subcutaneous fat area ratio are associated with long-term outcomes of elderly gastric cancer patients after gastrectomy

Langenbeck s Archives of Surgery ◽

10.1007/s00423-021-02092-1 ◽

2021 ◽

Author(s):

Yusuke Taki ◽

Shinsuke Sato ◽

Eiji Nakatani ◽

Kazuya Higashizono ◽

Erina Nagai ◽

...

Keyword(s):

Gastric Cancer ◽

Skeletal Muscle ◽

Cancer Patients ◽

Subcutaneous Fat ◽

Area Ratio ◽

Long Term Outcomes ◽

Skeletal Muscle Index ◽

Gastric Cancer Patients

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Impact of Combination Epidural and General Anesthesia on the Long-Term Survival of Gastric Cancer Patients: A Retrospective Study

Medical Science Monitor ◽

10.12659/msm.899543 ◽

2016 ◽

Vol 22 ◽

pp. 2379-2385 ◽

Cited By ~ 10

Author(s):

Jiangling Wang ◽

Wenjing Guo ◽

Qicheng Wu ◽

Runze Zhang ◽

Jun Fang

Keyword(s):

Gastric Cancer ◽

Retrospective Study ◽

General Anesthesia ◽

Cancer Patients ◽

Term Survival ◽

Long Term Survival ◽

Gastric Cancer Patients

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Does high body mass index negatively affect the surgical outcome and long-term survival of gastric cancer patients who underwent gastrectomy: A systematic review and meta-analysis

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.09.007 ◽

2018 ◽

Vol 44 (12) ◽

pp. 1971-1981 ◽

Cited By ~ 7

Author(s):

Bochao Zhao ◽

Jingting Zhang ◽

Di Mei ◽

Rui Luo ◽

Huiwen Lu ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Body Mass Index ◽

Cancer Patients ◽

Surgical Outcome ◽

Meta Analysis ◽

High Body Mass Index ◽

Term Survival ◽

Gastric Cancer Patients

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Clinical and Oncological Value of Preoperative BMI in Gastric Cancer Patients: A Single Center Experience

Gastroenterology Research and Practice ◽

10.1155/2015/810134 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Costantino Voglino ◽

Giulio Di Mare ◽

Francesco Ferrara ◽

Lorenzo De Franco ◽

Franco Roviello ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Blood Proteins ◽

Term Survival ◽

Long Term Survival ◽

Single Center Experience ◽

Group B ◽

Gastric Cancer Patients ◽

The Impact

Introduction. The impact of preoperative BMI on surgical outcomes and long-term survival of gastric cancer patients was investigated in various reports with contrasting results.Materials & Methods. A total of 378 patients who underwent a surgical resection for primary gastric cancer between 1994 and 2011 were retrospectively studied. Patients were stratified according to BMI into a normal group (<25, group A), an overweight group (25–30, group B), and an obesity group (≥30, group C). These 3 groups were compared according to clinical-pathological characteristics, surgical treatment, and long-term survival.Results. No significant correlations between BMI and TNM (2010), UICC stage (2010), Lauren’s histological type, surgical results, lymph node dissection, and postoperative morbidity and mortality were observed. Factors related to higher BMI were male genderP<0.05, diabetesP<0.001, and serum blood proteinsP<0.01. A trend to fewer lymph nodes retrieved during gastrectomy with lymphadenectomy in overweight patients (B and C groups) was observed, although not statistically significant. There was no difference in overall survival or disease-specific survival between the three groups.Conclusion. According to our data, BMI should not be considered a significant predictor of postoperative complications or long-term result in gastric cancer patients.

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Prognostic Indicators in Stage IV Surgically Treated Gastric Cancer Patients: A Retrospective Multi-Institutional Study

Digestive Surgery ◽

10.1159/000488775 ◽

2018 ◽

Vol 36 (4) ◽

pp. 331-339

Author(s):

Alberto Biondi ◽

Domenico D’Ugo ◽

Ferdinando Cananzi ◽

Stefano Rausei ◽

Federico Sicoli ◽

...

Keyword(s):

Gastric Cancer ◽

Adjuvant Chemotherapy ◽

Cancer Patients ◽

Residual Disease ◽

Stage Iv ◽

Long Term Results ◽

Stage Iv Gastric Cancer ◽

Short And Long Term ◽

Gastric Cancer Patients

Introduction: The role of gastric resection in treating metastatic gastric adenocarcinoma is controversial. In the present study, we reviewed the short- and long-term outcomes of stage IV patients undergoing surgery. Methods: A retrospective review was conducted that assessed patients undergoing elective surgery for incurable gastric carcinoma. Short- and long-term results were evaluated. Results: A total of 122 stage IV gastric cancer patients were assessed. Postoperative mortality was 5.7%, and the overall rate of complications was 35.2%. The overall survival rate at 1 and 3 years was 58 and 19% respectively; the median survival was 14 months. Improved survival was observed for the factors age less than 60 years (p = 0.015), site of metastases (p = 0.022), extended lymph node dissection (p = 0.044), absence of residual disease after surgery (p = 0.001), and administration of adjuvant chemotherapy (p = 0.016). Multivariate analysis showed that residual disease and adjuvant chemotherapy were independent prognostic factors. Conclusions: The results of this study suggest that surgery combined with systemic chemotherapy in selected patients with stage IV gastric cancer can improve survival.

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