Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer

Background/Aims: Identification of nutritional indicators to predict short-term and long-term outcomes is necessary to provide appropriate treatment to patients with gastric cancer. Methods: We designed an analysis of a multicenter dataset of patients with gastric cancer who underwent gastrectomy between 2010 and 2014. We enrolled 842 eligible patients who had stage II/III gastric cancer. The area under the curve (AUC) values were compared among prognostic nutritional index (PNI), calculated as 10 × albumin g/dL + 0.005 × total lymphocyte count/mm3, and its constituents, and the predictive value of preoperative PNI for postoperative short-term and long-term outcomes was evaluated. Results: Preoperative PNI exhibited higher AUC values (0.719) for 1-year survival than its constituents, and the optimal cutoff value was 47. The disease-free and overall survival of patients in the PNI-low group were significantly shorter compared with those in the PNI-high group. The prognostic difference between the PNI-high and PNI-low groups was significantly greater in the subgroup of patients who underwent total gastrectomy. Clinically relevant postoperative complications were more frequently observed in the PNI-low group. Conclusions: The preoperative PNI is a useful predictor reflecting the incidence of complications after gastrectomy and the prognosis of patients with stage II/III gastric cancer.

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Neutrophil-to-lymphocyte ratio (NLR) to predict the short-term and long-term outcomes of gastric cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e15560 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e15560-e15560

Author(s):

Ryoichi Miyamoto ◽

Satoshi Inagawa ◽

Naoki Sano ◽

Sosuke Tadano ◽

Masayoshi Yamamoto

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Predictive Value ◽

Disease Free Survival ◽

Perioperative Outcomes ◽

Survival Times ◽

Long Term Outcomes ◽

Short Term ◽

Gastric Cancer Patients

e15560 Background: Preoperative NLR was well known as highly repeatable, cost-effective and widely available long-term postoperative prognostic marker of gastric cancer patients. However, the utility of preoperative NLR to predict short-term outcomes in gastric cancer patients remains unclear. In this study, we addressed whether the preoperative NLR is a predictive value of short-term outcome in gastric cancer patients. Methods: We retrospectively evaluated 154 consecutive gastric cancer patients. Mean NLR was calculated, and 3.5 was set as cut-off value. The patient characteristics and perioperative outcomes were respectively compared. In addition, median survival times (MSTs) were also compared. In terms of stage II/III (UICC 7th) gastric cancer patients, median disease-free survival times (MDFSTs) were compared between the two groups. Results: The patients were then divided into two groups: low-NLR group (n = 110) and high-NLR group (n = 44). Among low-NLR group and high-NLR group, significant differences were respectively observed in preoperative symptoms [56 (51%) vs. 31 (70%); p = 0.027] and perioperative outcomes including postoperative complications [3 (2.7%) vs. 5 (11.3%); p = 0.015], intraoperative blood loss (158 ± 168 g vs. 232 ± 433 g; p = 0.022), and intraoperative blood transfusion [0 vs. 3 (6.8%); p = 0.042]. MSTs and MDFSTs were significantly differed (812 vs. 594 days; p = 0.04, 848 vs. 475 days; p = 0.03, respectively). Conclusions: The present study indicated that preoperative NLR influenced not only long-term outcomes but also perioperative outcomes in gastric cancer patients. Preoperative NLR is also a useful predictive value of short-term outcomes in gastric cancer patients.

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Prognostic factors for short-term and long-term outcomes of gastric cancer surgery for elderly patients: 10 years of experience at a single tertiary care center

Updates in Surgery ◽

10.1007/s13304-018-0548-y ◽

2018 ◽

Vol 70 (2) ◽

pp. 265-271 ◽

Cited By ~ 1

Author(s):

Stefano de Pascale ◽

Daniele Belotti ◽

Andrea Celotti ◽

Eleonora Maddalena Minerva ◽

Vittorio Quagliuolo ◽

...

Keyword(s):

Gastric Cancer ◽

Prognostic Factors ◽

Elderly Patients ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Long Term Outcomes ◽

Short Term ◽

Gastric Cancer Surgery

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Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-020-02080-7 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Jianglei Ma ◽

Xiaoyao Li ◽

Shifu Zhao ◽

Ruifu Zhang ◽

Dejun Yang

Keyword(s):

Gastric Cancer ◽

Systematic Review ◽

Robotic Surgery ◽

Laparoscopic Gastrectomy ◽

Resection Margin ◽

Meta Analysis ◽

Long Term Outcomes ◽

Short Term ◽

Meta Analyses

Abstract Background To date, robotic surgery has been widely used worldwide. We conducted a systematic review and meta-analysis to evaluate short-term and long-term outcomes of robotic gastrectomy (RG) in gastric cancer patients to determine whether RG can replace laparoscopic gastrectomy (LG). Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was applied to perform the study. Pubmed, Cochrane Library, WanFang, China National Knowledge Infrastructure (CNKI), and VIP databases were comprehensively searched for studies published before May 2020 that compared RG with LG. Next, two independent reviewers conducted literature screening and data extraction. The quality of the literature was assessed using the Newcastle-Ottawa Scale (NOS), and the data analyzed using the Review Manager 5.3 software. Random effects or fixed effects models were applied according to heterogeneity. Results A total of 19 studies including 7275 patients were included in the meta-analyses, of which 4598 patients were in the LG group and 2677 in the RG group. Compared with LG, RG was associated with longer operative time (WMD = −32.96, 95% CI −42.08 ~ −23.84, P < 0.001), less blood loss (WMD = 28.66, 95% CI 18.59 ~ 38.73, P < 0.001), and shorter time to first flatus (WMD = 0.16 95% CI 0.06 ~ 0.27, P = 0.003). There was no significant difference between RG and LG in terms of the hospital stay (WMD = 0.23, 95% CI −0.53 ~ 0.98, P = 0.560), overall postoperative complication (OR = 1.07, 95% CI 0.91 ~ 1.25, P = 0.430), mortality (OR = 0.67, 95% CI 0.24 ~ 1.90, P = 0.450), the number of harvested lymph nodes (WMD = −0.96, 95% CI −2.12 ~ 0.20, P = 0.100), proximal resection margin (WMD = −0.10, 95% CI −0.29 ~ 0.09, P = 0.300), and distal resection margin (WMD = 0.15, 95% CI −0.21 ~ 0.52, P = 0.410). No significant differences were found between the two treatments in overall survival (OS) (HR = 0.95, 95% CI 0.76 ~ 1.18, P = 0.640), recurrence-free survival (RFS) (HR = 0.91, 95% CI 0.69 ~ 1.21, P = 0.530), and recurrence rate (OR = 0.90, 95% CI 0.67 ~ 1.21, P = 0.500). Conclusions The results of this study suggested that RG is as acceptable as LG in terms of short-term and long-term outcomes. RG can be performed as effectively and safely as LG. Moreover, more randomized controlled trials comparing the two techniques with rigorous study designs are still essential to evaluate the value of the robotic surgery for gastric cancer.

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Safety, effectiveness, and rapid adaptation of robotic gastrectomy for advanced gastric cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.161 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 161-161

Author(s):

Lin Chen ◽

Jiyang Li ◽

Hongqing Xi ◽

Yunhe Gao ◽

Jianxin Cui ◽

...

Keyword(s):

Gastric Cancer ◽

Advanced Gastric Cancer ◽

Laparoscopic Gastrectomy ◽

Open Gastrectomy ◽

Robotic Gastrectomy ◽

Long Term Outcomes ◽

Short Term ◽

Clinicopathologic Characteristics ◽

Safety Effectiveness

161 Background: As robotic surgery techniques advances, robotic gastrectomy has emerged as an alternative modality for advanced gastric cancer (AGC). However, there is a lack of supporting evidence regarding the safety, effectiveness and surgeon acceptance of robotic gastrectomy for AGC patients. Methods: An ambispective cohort study was conducted. We compared surgical and oncological outcomes between robotic and traditional laparoscopic gastrectomy for AGC patients. The Cumulative Sum (CUSUM) method was developed and used to analyze the learning curves of robotic gastrectomy for AGC by two surgeons who had different surgical experience. Results: From August 2011 to June 2017, a total of 134 AGC patients were performed robotic gastrectomy by surgeon A (n = 42) and surgeon B (n = 147). And there were 238 AGC patients received traditional laparoscopic gastrectomy which performed by the same two surgeons over the same period. There were no significant differences between the two operation methods regarding the clinicopathologic characteristics and long-term outcomes (p=0.737). However, robotic gastrectomy group had less operative blood loss (229 ml vs. 240 ml, p=0.031) and less Clavien-Dindo Grade II to IV complications (p=0.006) than laparoscopic group. Clinicopathologic characteristics, short-term and long-term outcomes of the patients treated by surgeon A and surgeon B are similarity. CUSUM analysis showed that operative time reached a stable state after around 12 cases in surgeon A who had more open gastrectomy experience than laparoscopic gastrectomy experience, and 21 cases in surgeon B who had more laparoscopic gastrectomy experience than open gastrectomy experience. The stable operation time was 242 min for surgeon A and 236 min for surgeon B. The number of lymph node dissections was 38 for surgeon A and 28 for surgeon B during their capacity-increasing phase. Conclusions: Robotic gastrectomy achieved superior short-term outcomes and comparable long-term outcomes compared with traditional laparoscopic gastrectomy for AGC patients. Surgeons with sufficient experience in either open or laparoscopic gastrectomy can rapidly overcome the learning curve and performed gastrectomy for AGC patients safely.

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