Retrospective analysis of 1‐year mortality after gastric cancer surgery: Total intravenous anesthesia versus volatile anesthesia

Background Previous experimental and clinical studies have shown that anesthetic agents have varying effects on cancer prognosis; however, the results were inconsistent among these studies. The authors compared overall and recurrence-free survival in patients given volatile or intravenous anesthesia for digestive tract cancer surgery. Methods The authors selected patients who had elective esophagectomy, gastrectomy, hepatectomy, cholecystectomy, pancreatectomy, colectomy, and rectal cancer surgery from July 2010 to March 2018 using the Japanese Diagnosis Procedure Combination database. Patients were divided into a volatile anesthesia group (desflurane, sevoflurane, or isoflurane with/without nitrous oxide) and a propofol-based total intravenous anesthesia group. The authors hypothesized that total intravenous anesthesia is associated with greater overall and recurrence-free survival than volatile anesthesia. Subgroup analyses were performed for each type of surgery. Results The authors identified 196,303 eligible patients (166,966 patients in the volatile anesthesia group and 29,337 patients in the propofol-based total intravenous anesthesia group). The numbers (proportions) of death in the volatile anesthesia and total intravenous anesthesia groups were 17,319 (10.4%) and 3,339 (11.4%), respectively. There were no significant differences between the two groups in overall survival (hazard ratio, 1.02; 95% CI, 0.98 to 1.07; P = 0.28) or recurrence-free survival (hazard ratio, 0.99; 95% CI, 0.96 to 1.03; P = 0.59), whereas instrumental variable analyses showed a slight difference in recurrence-free survival (hazard ratio, 0.92; 95% CI, 0.87 to 0.98; P = 0.01). Subgroup analyses showed no significant difference in overall or recurrence-free survival between the groups in any type of surgery. Conclusions Overall and recurrence-free survival were similar between volatile and intravenous anesthesia in patients having digestive tract surgery. Selection of the anesthetic approach for these patients should be based on other factors. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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The long-term survival outcomes of gastric cancer patients with total intravenous anesthesia or inhalation anesthesia: a single-center retrospective cohort study

BMC Cancer ◽

10.1186/s12885-021-08946-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei-Wei Wu ◽

Wei-Han Zhang ◽

Wei-Yi Zhang ◽

Kai Liu ◽

Xin-Zu Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Total Intravenous Anesthesia ◽

Survival Outcomes ◽

Intravenous Anesthesia ◽

Inhalation Anesthesia ◽

Gastric Cancer Surgery ◽

Significant Difference ◽

Gastric Cancer Patients

Abstract Background The relationship between the type of anesthesia and the survival outcomes of gastric cancer patients is uncertain. This study compared the overall outcome of gastric cancer patients after surgery with total intravenous anesthesia (TIVA) or inhalation anesthesia (IHA). Methods Clinicopathological variables of gastric cancer patients were retrieved from the database of the Surgical Gastric Cancer Patient Registry in West China Hospital, Sichuan University. Patients were grouped according to whether they received TIVA or IHA during the operation. Propensity score (PS) matching was used to balance the baseline variables, and survival outcomes were compared between these two groups. In addition, studies comparing survival outcomes between TIVA and IHA used for gastric cancer surgery and published before April 20th, 2020, were identified, and their data were pooled. Results A total of 2827 patients who underwent surgical treatment from Jan 2009 to Dec 2016 were included. There were 323 patients in the TIVA group and 645 patients in the IHA group, with 1:2 PS matching. There was no significant difference in overall survival outcomes between the TIVA and IHA groups before matching the cohort (p = 0.566) or after matching the cohort (p = 0.679) by log-rank tests. In the Cox hazard regression model, there was no significant difference between the TIVA and IHA groups before (HR: 1.054, 95% CI: 0.881–1.262, p = 0.566) or after (HR: 0.957, 95% CI: 0.779–1.177, p = 0.679) PS matching. The meta-analysis of survival outcomes between the TIVA and IHA groups found critical statistical value in the before PS matching cohort (HR 0.74, 95% CI: 0.57–0.96 p < 0.01) and after PS matching cohort (HR: 0.65, 95% CI: 0.46–0.94, p < 0.01). Conclusions Combined with the results of previous studies, total intravenous anesthesia has been shown to be superior to inhalation anesthesia in terms of overall survival for gastric cancer patients undergoing surgical treatment. The selection of intravenous or inhalation anesthesia for gastric cancer surgery should take into account the long-term prognosis of the patient.

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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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