Prediction of Postoperative Mortality in Patients with Organ Failure After Gastric Cancer Surgery

4092 Background: Numerous studies suggest positive relationship between hospital volume and cancer treatment outcomes, the surgeon’s experience and specialty training may also be important. This was examined in a high volume hospital in Shanghai among patients who underwent gastric cancer (GC) surgery. Methods: Data on consecutive patients (pts) undergoing R0 or R1 GC resection in Zhongshan hospital between January 2003 and June 2010 were collected and analyzed. Follow-up on pts who were non-Shanghai residents were less complete therefore excluded. Post-operative mortality, pathologic results and survival outcome for pts treated by surgical training, i.e., sub-specialized vs., non-specialized, were obtained. Survival was calculated by the Kaplan-Meier method and Log-rank test was used to determine statistical significance. To determine whether sub-specialty surgical training was an independent factor for overall survival (OS), univariate and multivariate analyses were performed using Cox proportional hazards regression. Results: Total 5,046 pts underwent R0 or R1 GC resection were identified.1594 pts had complete covariate data, survival information and were included in the study. Of them, the sub-specialized group included 217 cases treated by 3 surgeons, while the non-specialized group included 1377 cases treated by 52 surgeons. 5-year cumulative OS was higher in the sub-specialized group (62.9% vs. 54.6%, p=0.032). Multivariate analysis showed that tumor stage(p<0.001), location of tumor (p=0.003), vascular invasion (p<0.001) and surgeon (HR=1.54, p=0.001) were all associated with OS. The incidence of positive margin was higher in non-specialized group (2.0% vs. 2.7%, p<0.001) and the probability of retrieved lymph nodes less than 15 was more in non-specialized group (25.9% vs. 7.3%, p<0.001). Postoperative mortality was also higher in non-specialized group than in specialized group(1.5% vs. 0.9%, p<0.001). Conclusions: In high volume general hospital, sub-specialty training is desirable in gastric cancer surgery, the quality of gastric cancer surgery can be further improved by sub-specialty training leading to better treatment outcome.

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Postoperative mortality after esophageal and gastric cancer surgery: Does age still matter? Results from a nationwide study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.122 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 122-122

Author(s):

Christophe Mariette ◽

Arnaud Pasquer ◽

Florence Renaud ◽

Flora Hec ◽

Anne Gandon ◽

...

Keyword(s):

Gastric Cancer ◽

Age Groups ◽

Postoperative Mortality ◽

Linear Increase ◽

Cancer Surgery ◽

Charlson Score ◽

Cumulative Impact ◽

Study Objective ◽

Gastric Cancer Surgery ◽

The Impact

122 Background: More than age, patient comorbidity is increasingly considered as the prominent predictor of postoperative mortality (POM) in esophageal and gastric cancer surgery, leading a growing number of elderly to be operated on. However, the respective impact of age and comorbidity on POM remains to be elucidated. The study objective was to investigate the impact of age on POM according to patient comorbidity. Methods: All consecutive patients who underwent esophageal or gastric cancer surgery between 2010 and 2012 in France were included (n = 11,196). The 30-day POM was compared by age groups (20-39, 40-59, 60-79, ≥ 80) and stratified according to the Charlson score (0, 1-2, ≥ 3). The consistency across esophageal (n = 3286) and gastric (n = 7910) subgroups and variations between 30-day and 90-day POM were analyzed. Results: Patients ≥ 60 years represented 73.8% of cases. A linear increase in 30-day and 90-day POM was observed with increasing age, with rates of 0.9% and 2.1%, 2.4% and 5.4%, 4.8% and 8.8%, and 9.3% and 15.9% in 20-39, 40-59, 60-79, ≥ 80 years age groups, respectively ( P< 0.001). Comparing 20-39 and ≥ 80 years age groups, 30-day POM was 1.0% vs. 7.0% for Charlson 0 ( P< 0.001), 3.1% vs. 11.1% for Charlson1-2 ( P< 0.001) and 0% vs. 19.5% for Charlson ≥ 3 ( P= 0.020) patients. A similar linear increase of POM by growing age groups was observed for 90-day POM and in esophagus and stomach subgroups. By multivariable analysis age groups (OR 1.03 95%CI 1.02-1.04, p < 0.001) and Charlson score (OR 1.56 95%CI 1.43-1.70, p < 0.001) were independent predictors of POM. Conclusions: Age and patient comorbidity have a similar and cumulative impact on POM after esophageal and gastric cancer surgery.

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Value of Geriatric Frailty and Nutritional Status Assessment in Predicting Postoperative Mortality in Gastric Cancer Surgery

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-013-2443-7 ◽

2014 ◽

Vol 18 (3) ◽

pp. 439-446 ◽

Cited By ~ 61

Author(s):

Juul J. W. Tegels ◽

M. F. G. de Maat ◽

K. W. E. Hulsewé ◽

A. G. M. Hoofwijk ◽

J. H. M. B. Stoot

Keyword(s):

Gastric Cancer ◽

Nutritional Status ◽

Postoperative Mortality ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Status Assessment

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Possible impact of COVID-19 on gastric cancer surgery in Italy

Minerva Chirurgica ◽

10.23736/s0026-4733.20.08381-9 ◽

2020 ◽

Vol 75 (5) ◽

Author(s):

Fausto Rosa ◽

Sergio Alfieri

Keyword(s):

Gastric Cancer ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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Identification of Significant Genes with Peritoneal Metastasis After Gastric Cancer Surgery via Bioinformatical Analysis

SSRN Electronic Journal ◽

10.2139/ssrn.3471980 ◽

2019 ◽

Author(s):

Shengjie Lin ◽

Tao Jiang ◽

Guizhen Wen ◽

Wenyu Gao ◽

Xuan Gao ◽

...

Keyword(s):

Gastric Cancer ◽

Peritoneal Metastasis ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Bioinformatical Analysis

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Nutrition update in gastric cancer surgery

Annals of Gastroenterological Surgery ◽

10.1002/ags3.12351 ◽

2020 ◽

Vol 4 (4) ◽

pp. 360-368 ◽

Cited By ~ 1

Author(s):

Takeshi Kubota ◽

Katsutoshi Shoda ◽

Hirotaka Konishi ◽

Kazuma Okamoto ◽

Eigo Otsuji

Keyword(s):

Gastric Cancer ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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Risk of venous thromboembolism in patients undergoing gastric cancer surgery: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-033267 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033267

Author(s):

Dengfeng Wang ◽

Yang Yu ◽

Pengxian Tao ◽

Dan Wang ◽

Yajing Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Venous Thromboembolism ◽

Evaluation Method ◽

Clinical Decision Making ◽

Meta Analysis ◽

Cancer Surgery ◽

Published Data ◽

Gastric Cancer Surgery ◽

Positive Prevention

IntroductionVenous thromboembolism (VTE) is a serious life-threatening complication in patients with gastric cancer. Abnormal coagulation function and tumour-related treatment may contribute to the occurrence of VTE. Many guidelines considered that surgical treatment would put patients with cancer at high risk of VTE, so positive prevention is needed. However, there are no studies that have systematically reviewed the postoperative risk and distribution of VTE in patients with gastric cancer. We thus conduct this systematic review to determine the risk of VTE in patients with gastric cancer undergoing surgery and provide some evidence for clinical decision-making.Methods and analysisStudies reporting the incidence of VTE after gastric cancer surgery will be included. Primary studies of randomised controlled trials, cohort studies, population-based surveys and cross-sectional studies are eligible for this review and only studies published in Chinese and English will be included. We will search the Medline, Embase, Web of Science, CBM, CNKI and Wanfang data from their inception to November 2019. Two reviewers will independently select studies and extract data. The quality of each included study will be assessed with tools corresponding to their study design. Meta-analysis will be used to pool the incidence data from included studies. Heterogeneity of the estimates across studies will be assessed, if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method is applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus ethical approval is not required. The results of this review will be sought for publication.PROSPERO registration numberCRD42019144562

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Prognosis after surgery for gastric adenocarcinoma in the Swedish Gastric Cancer Surgery Study (SWEGASS)

Acta Oncologica ◽

10.1080/0284186x.2021.1874619 ◽

2021 ◽

pp. 1-8

Author(s):

Johannes Asplund ◽

Eivind Gottlieb-Vedi ◽

Wilhelm Leijonmarck ◽

Fredrik Mattsson ◽

Jesper Lagergren

Keyword(s):

Gastric Cancer ◽

Gastric Adenocarcinoma ◽

Cancer Surgery ◽

Gastric Cancer Surgery

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A Prospective Multicenter Observational Study of Venous Thromboembolism after Gastric Cancer Surgery (SHISA-1601)

European Surgical Research ◽

10.1159/000514309 ◽

2021 ◽

pp. 1-10

Author(s):

Sachiko Kaida ◽

Toru Miyake ◽

Satoshi Murata ◽

Tsuyoshi Yamaguchi ◽

Takeshi Tatsuta ◽

...

Keyword(s):

Gastric Cancer ◽

Venous Thromboembolism ◽

Blood Transfusion ◽

Observational Study ◽

Characteristic Curve ◽

Cancer Surgery ◽

Gastric Cancer Surgery ◽

Multicenter Observational Study ◽

Prospective Multicenter Observational Study ◽

D Dimer

Introduction: This study aimed to clarify the frequency and risk factors of intercurrent venous thromboembolism (VTE) in patients undergoing major curative gastric cancer surgery. Methods: This prospective, multicenter, observational study included patients with gastric cancer who underwent radical gastrectomy at 5 hospitals between June 2016 and May 2018. Patients who were preoperatively administered anticoagulants were excluded. Results: A total of 126 patients were eligible to participate. VTE occurred within 9 days postoperatively in 5 cases (4.0%; 2 symptomatic and 3 asymptomatic). Postoperative day (POD) 1 plasma D-dimer and soluble fibrin (SF) levels were significantly higher in the VTE group than in the non-VTE group. Receiver-operating characteristic curve (ROC) analysis indicated a statistically significant ability of POD 1 D-dimer and SF levels to predict postoperative VTE development after gastrectomy; this finding was reflected by an area under the curve (AUC) of 0.97 (95% CI 0.92–1.0) and 0.87 (95% CI 0.74–1.0), respectively. Cutoff values of D-dimer (24.6 µg/mL) and SF (64.1 µg/mL) were determined. Intraoperative blood transfusion (odds ratio [OR] 7.86), POD 1 D-dimer ≥24.6 µg/mL (OR 17.35), and POD 1 SF ≥64.1 µg/mL (OR 19.5) were independent predictive factors for postoperative VTE (p < 0.05). Conclusion: VTE occurred in 4.0% patients (1.6% symptomatic and 2.4% asymptomatic) after gastric cancer surgery; however, with an early diagnosis and anticoagulant therapy, no patients experienced progression. Careful observation of patients with a high risk for VTE, including intraoperative blood transfusion and high POD 1 D-dimer or SF levels, would contribute to the early detection of VTE.

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