scholarly journals The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications in Patients with Gastric Cancer

2021 ◽  
Author(s):  
Yota Shimoda ◽  
Hirohito Fujikawa ◽  
Keisuke Komori ◽  
Hayato Watanabe ◽  
Kosuke Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Predictive Factor ◽  
Proportional Hazards Model ◽  
Prognostic Score ◽  
Surgical Techniques ◽  
Glasgow Prognostic Score ◽  
Cox Proportional Hazards Model ◽  
Stage Ii ◽  
Independent Predictive Factor

Abstract Purpose Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC. Methods This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model. Results The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037). Conclusion The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promote safe and minimally invasive surgery that we expect will improve outcomes in patients with a GPS of 1 or 2.

scholarly journals The Glasgow Prognostic Score Before Curative Resection May Predict Postoperative Complications In Patients With Gastric Cancer

2021 ◽  
Author(s):  
Yota Shimoda ◽  
Hirohito Fujikawa ◽  
Keisuke Komori ◽  
Hayato Watanabe ◽  
Kosuke Takahashi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Predictive Factor ◽  
Proportional Hazards Model ◽  
Prognostic Score ◽  
Surgical Techniques ◽  
Glasgow Prognostic Score ◽  
Cox Proportional Hazards Model ◽  
Stage Ii ◽  
Independent Predictive Factor

Abstract Purpose: Despite improvements in surgical techniques and devices and perioperative care of gastric cancer (GC), the rate of postoperative complications still has not decreased. If patients at high risk for postoperative complications could be identified early using biomarkers, these complications might be reduced. In this study, we investigated usefulness of the preoperative Glasgow Prognostic Score (GPS) as a predictive factor for complications after surgery in patients with stage II/III GC.Methods: This study retrospectively analyzed the outcomes of 424 patients who underwent curative surgery for pathological Stage II/III GC from February 2007 to July 2019 at a single center. The GPS was assessed within 4 days before surgery. To identify independent risk factors for postoperative complications, univariate and multivariate analyses were performed using a Cox proportional hazards model.Results: The numbers of patients with a GPS of 0, 1, and 2 were 357, 55, and 12, respectively. The rate of complications after surgery was significantly higher among patients with a GPS of 1 or 2 than among patients with a GPS of 0 (p = 0.008). Multivariate analysis identified a GPS of 1 or 2 as an independent predictive factor for postoperative complications (p = 0.037). Conclusion: The preoperative GPS may be a useful predictive factor for postoperative complications in patients with stage II/III GC. Being aware of the risk of complications after surgery as indicated by the GPS before surgery may promotes safe and minimally invasive surgery that we expect will improve outcomes in these patients.

Prognostic value of modified Glasgow Prognostic Score (mGPS) and neutrophil-lymphocyte ration (NLR) after curative resection for gastric cancer.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 295-295
Author(s):  
Yusuke Shimodaira ◽  
Sachie Koike ◽  
Yusuke Takahashi ◽  
Masao Okada ◽  
Kaori Hayashibara ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Curative Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Rank Test ◽  
Independent Predictive Factor ◽  
Gastric Cancer Patients

295 Background: Several biomarkers based on serum chemistry have been reported to be associated with the prognosis of several types of cancers. This retrospective study aimed to investigate the prognostic value of preoperative mGPS and NLR after curative resection for gastric cancer. Methods: A total of 295 patients who underwent curative gastrectomy for primary gastric cancer at our institution from January 2013 to December 2017 were enrolled in this study. The mGPS was calculated by CRP and Alb using standard thresholds ( > 0.5 mg/dL for CRP and < 3.5 g/dL for Alb). The NLR was defined as absolute neutrophil count divided by absolute lymphocyte count. The survival curves of patients stratified by each parameter were plotted by the Kaplan-Meier method and compared by log-rank test. Multivariate Cox proportional hazards regression models were used to select parameters independently correlated with prognosis. Results: The median follow-up time was 36.7 months, and 29 patients died during follow-up. The estimated 5-year survival rate was 83.1%. Results from the univariate analyses showed mGPS2 (CRP > 0.5 mg/dL and Alb < 3.5 g/dL) was associated with poor survival while NLR and NLRc was not (P < 0.001, P = 0.506, and P = 0.423, respectively). In the multivariate analyses, the mGPS2 was identified as an independent predictive factor for OS in gastric cancer patients after curative resection (HR: 2.624; 95% CI: 1.058-6.505; P = 0.037). Conclusions: Preoperative mGPS2 was associated with worse survival after curative resection of gastric cancer patients. Based on our study, those with mPGS2 may be warranted to receive additional therapy or nutritional support to acquire better survival.

Role of systemic immune-inflammatory index, tumor infiltrating neutrophils and PD-1+ T cells to predict the postoperative recurrence after S-1 adjuvant chemotherapy for gastric cancer: A retrospective study.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 74-74
Author(s):  
Hiroaki Tanaka ◽  
Tatsuro Tamura ◽  
Soichiro Hiramatsu ◽  
Kazuya Muguruma ◽  
Yuichiro Miki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
T Cells ◽  
Adjuvant Chemotherapy ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Glasgow Prognostic Score ◽  
Predictive Marker ◽  
Stage Ii ◽  
University Hospital ◽  
Neutrophil Lymphocyte Ratio

74 Background: The adjuvant chemotherapy with S-1 is the standard treatment for Stage II/III gastric cancer in Japan. Immunological status of host is critical for treatment outcome. Several investigators showed that systemic immune-inflammaotry indexes including neutrophil lymphocyte ratio (NLR) and modified Glasgow Prognostic Score (mGPS) well reflected the tumor progression. Methods: We analyzed clinical data obtained from 170 patients with pathological stage II/III gastric cancer who underwent surgery followed by S-1 adjuvant chemotherapy at Osaka City University Hospital between 2006 and 2015. Tumor infiltrating cells were detected by immunohistochemistry. Results: We found recurrent diseases in 70 (41%) patients including 15 in stage II and 55 in stage III. In univariate analysis using Cox proportion model, 2 grade of mGPS, the increase value of post-operative CEA, CA19-9, number of lymphocytes and NLR were associated with recurrence. Post-operative elevation of CEA and NLR were identified as independent risk factors for recurrence in multivariate analysis. Increase value of pre-operative NLR and CEA was significantly associated with early recurrent within one year after surgery. Tumor infiltrating neutrophils and PD-1+ T cells had correlated with the increase of pre-operative NLR and CEA value, respectively. Patients with low PD-1+T cells and low neutrophils had better prognosis than those with high infiltration. Conclusions: Post-surgical elevation of CEA and NLR value were useful as a predictive marker for recurrence in patients treated with S-1 adjuvant chemotherapy after surgery for gastric cancer. Early recurrence had correlated with tumor infiltrating neutrophils and PD-1+T cells. Our results suggested that systemic and local immune suppression should be an important element to exacerbate prognosis after chemotherapy for resectable gastric cancer.

scholarly journals Significance of the Glasgow Prognostic Score in Predicting the Postoperative Outcome of Patients with Stage III Gastric Cancer

2019 ◽  
Vol 8 (9) ◽  
pp. 1448 ◽  
Author(s):  
Shun-Wen Hsueh ◽  
Keng-Hao Liu ◽  
Chia-Yen Hung ◽  
Yung-Chia Kuo ◽  
Chun-Yi Tsai ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Postoperative Complications ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Complication Rates ◽  
Term Survival ◽  
D2 Gastrectomy ◽  
Admission Rates

This study aimed at investigating the ability of a preoperative Glasgow prognostic score (GPS) to predict postoperative complications and survival outcomes in patients with stage III gastric cancer undergoing D2 gastrectomy. We retrospectively reviewed data from 272 such patients, treated between 2010 and 2016, at a Taiwanese medical center. The patients were categorized according to their GPS. In total, 36.8%, 48.5%, and 14.7% of the patients were assigned to groups with a GPS of 0, 1, and 2, respectively. Overall surgical complication rates in these groups were 30%, 45.5%, and 52.5% (p = 0.016); postoperative intensive care unit admission rates were 10%, 14.4%, and 22.5% (p = 0.15); postoperative 30-day re-admission rates were 6%, 15.2%, and 20% (p = 0.034); and the in-hospital mortality rates were 1.0%, 1.5%, and 10.0%, respectively (p = 0.006). The median survival times of the patients were 42.9 months (95% confidence interval [CI], 29.1–56.6), 22.6 months (95% CI, 19.3–25.8), and 16.6 months (95% CI, 7.8–25.4), respectively (p< 0.001). A significant correlation was observed between the preoperative GPS, short-term postoperative complications, and long-term survival outcomes in patients with gastric cancer undergoing D2 gastrectomy. These findings recommend the usage of the GPS as a predictive and prognostic factor in patients with gastric cancer considering surgical resection.

The effect of delay of adjuvant chemotherapy on survival in patients with resected stage II and III gastric cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15144-e15144
Author(s):  
Minkyu Jung ◽  
Hyoung Soon Park ◽  
Han Na Park ◽  
Seungtaek Lim ◽  
Ji Soo Park ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Univariate Analysis ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Stage Ii ◽  
Hazards Model ◽  
Resected Stage

e15144 Background: Adjuvant chemotherapy improved survival in patients with gastric cancer. However, the association between the timing of adjuvant chemotherapy and survival has not been investigated. Methods: Patients with stage II and III gastric cancer who received adjuvant chemotherapy at Yonsei University Health System were included in this study. Time to adjuvant chemotherapy, relapse free survival (RFS), and overall survival (OS) were calculated from the day of surgery. RFS and OS were compared using log-rank test and multivariate analysis by the Cox proportional hazards model. Results: Among 675 patients, 226 patients (33.5%) began adjuvant chemotherapy within 1 month, 421 patients (60.1%) began adjuvant chemotherapy in 1 to 2 months, and 28 patients (4.1%) began adjuvant chemotherapy > 2 months after surgery. Intervals > 2 months between chemotherapy and surgery was associated with worse RFS and OS in both univariate analysis (RFS, p=0.039; OS, p=0.022, respectively) and a Cox proportional hazards model (RFS, hazard ratio [HR] =1.81, 95% confidential interval [CI] =1.05-3.12; OS, HR=1.96, 95% CI=1.11-3.47, respectively). Conclusions: Only 4.1% of patients initiated adjuvant chemotherapy >2 months after the date of curative surgery. Adjuvant chemotherapy delay > 2 months after surgical resection is associated with worse survival among patients with resected stage II and III gastric cancer.

scholarly journals Long-term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study

Gut ◽  
2017 ◽  
Vol 67 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Ka Shing Cheung ◽  
Esther W Chan ◽  
Angel Y S Wong ◽  
Lijia Chen ◽  
Ian C K Wong ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Proportional Hazards Model ◽  
Absolute Risk ◽  
Eradication Therapy ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model

ObjectiveProton pump inhibitors (PPIs) is associated with worsening of gastric atrophy, particularly in Helicobacter pylori (HP)-infected subjects. We determined the association between PPIs use and gastric cancer (GC) among HP-infected subjects who had received HP therapy.DesignsThis study was based on a territory-wide health database of Hong Kong. We identified adults who had received an outpatient prescription of clarithromycin-based triple therapy between year 2003 and 2012. Patients who failed this regimen, and those diagnosed to have GC within 12 months after HP therapy, or gastric ulcer after therapy were excluded. Prescriptions of PPIs or histamine-2 receptor antagonists (H2RA) started within 6 months before GC were excluded to avoid protopathic bias. We evaluated GC risk with PPIs by Cox proportional hazards model with propensity score adjustment. H2RA was used as a negative control exposure.ResultAmong the 63 397 eligible subjects, 153 (0.24%) developed GC during a median follow-up of 7.6 years. PPIs use was associated with an increased GC risk (HR 2.44, 95% CI 1.42 to 4.20), while H2RA was not (HR 0.72, 95% CI 0.48 to 1.07). The risk increased with duration of PPIs use (HR 5.04, 95% CI 1.23 to 20.61; 6.65, 95% CI 1.62 to 27.26 and 8.34, 95% CI 2.02 to 34.41 for ≥1 year, ≥2 years and ≥3 years, respectively). The adjusted absolute risk difference for PPIs versus non-PPIs use was 4.29 excess GC (95% CI 1.25 to 9.54) per 10 000 person-years.ConclusionLong-term use of PPIs was still associated with an increased GC risk in subjects even after HP eradication therapy.

scholarly journals Frailty is a useful predictive marker of postoperative complications after pancreaticoduodenectomy

2020 ◽  
Author(s):  
YUTAKA NAKANO ◽  
Yuki Hirata ◽  
Tatsuya Shimogawara ◽  
Toru Yamada ◽  
Koki Mihara ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Predictive Factor ◽  
Cardiovascular Health ◽  
Predictive Marker ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Independent Predictive Factor ◽  
Frail Patients ◽  
Soft Pancreas

Abstract BACKGROUND: Frailty results in a high risk for disability, hospitalization, and mortality. This study aimed to investigate perioperative details of frail patients who underwent pancreatectomy and whether frailty can be a predictive factor of postoperative complications, especially of clinically relevant postoperative pancreatic fistula (CR-POPF).METHODS: This retrospective study included patients who underwent pancreatectomy in our hospital between August 2016 and March 2019. The patients were divided into frail and pre-/non-frail groups. The diagnostic criteria were based on the Japanese version of the Cardiovascular Health Study.RESULTS: Of 93 patients, 11 (11.8%) and 82 (88.2%) were frail and pre-/non-frail patients, with median ages of 82 and 72 years, respectively (p=0.041). Postoperative complications (Clavien-Dindo ≧IIIa) were found in 8 and 32 patients (p=0.034), CR-POPF in 3 and 13 patients (p=0.346), and postoperative hospital stays were 21 and 17 days (p=0.041), respectively. On multivariate analysis, frailty was an independent predictive factor (odds ratio [OR] 5.604, 95.0% confidence interval [CI] 1.002-30.734; p=0.047) of postoperative complications (Clavien-Dindo ≧IIIa) after pancreaticoduodenectomy. On multivariate analysis, a soft pancreas (OR 5.696, 95.0% CI 1.142-28.149; p=0.034) was an independent and significant predictive factor of CR-POPF after pancreaticoduodenectomy.CONCLUSIONS: Frailty may be a useful predictive factor of postoperative complications in patients undergoing pancreaticoduodenectomy.

scholarly journals Preoperative prealbumin levels on admission as an independent predictive factor in patients with gastric cancer

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19196 ◽  
Author(s):  
Hongliang Zu ◽  
Huiling Wang ◽  
Chunfeng Li ◽  
Yingwei Xue
Keyword(s):  
Gastric Cancer ◽  
Predictive Factor ◽  
Independent Predictive Factor
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