Skip to main content

Advertisement

Log in

Surgical Complications in Gastric Cancer Patients Preoperatively Treated with Chemotherapy: Their Risk Factors and Clinical Relevance

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study was designed to identify risk factors and oncological value for the development of postoperative complications after gastrectomy in gastric cancer patients with preoperative chemotherapy.

Methods

A total of 123 gastric cancer patients who underwent gastrectomy after chemotherapy were enrolled in this study. The incidence, type, risk factors, and prognostic value of surgical complications were evaluated.

Results

The postoperative complication rate was 29.3% and mortality rate was 1.6%. The development of postoperative complications was associated with operation time (>200 min) and transfusion during surgery. The resection extent, preoperative chemotherapy cycles and regimens, tumor stage, and patients’ nutritional status were not predictive factors for the development of surgical complications. In the multivariate analysis, operation time was an independent risk factor for the development of postoperative complications (odds ratio, 3.813; P = 0.011). The median follow-up after surgery was 19 months. The 3-year, disease-free survival was 57.1% in patients without complications and 25.7% in patients with complications (P = 0.004). Multivariable analysis demonstrated postoperative complications were a significant prognostic factor for disease-free survival (hazard ratio, 2.676; P = 0.024).

Conclusions

The incidence of surgical complications was high in gastric cancer patients who received preoperative chemotherapy. Long operation time was a risk factor for surgical complications, and the development of postoperative complication was predictive of patients’ prognoses.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Pyrhonen S, Kuitunen T, Nyandoto P, Kouri M. Randomised comparison of fluorouracil, epidoxorubicin and methotrexate (FEMTX) plus supportive care with supportive care alone in patients with non-resectable gastric cancer. Br J Cancer. 1995;71(3):587–91.

    Article  PubMed  CAS  Google Scholar 

  2. Nakajima T. Gastric cancer treatment guidelines in Japan. Gastric Cancer. 2002;5(1):1–5.

    Article  PubMed  Google Scholar 

  3. Ajani JA, Mansfield PF, Lynch PM, et al. Enhanced staging and all chemotherapy preoperatively in patients with potentially resectable gastric carcinoma. J Clin Oncol. 1999;17(8):2403–11.

    PubMed  CAS  Google Scholar 

  4. Ajani JA, Mansfield PF, Janjan N, et al. Multi-institutional trial of preoperative chemoradiotherapy in patients with potentially resectable gastric carcinoma. J Clin Oncol. 2004;22(14):2774–80.

    Article  PubMed  CAS  Google Scholar 

  5. Sym SJ, Chang HM, Ryu MH, et al. Neoadjuvant docetaxel, capecitabine and cisplatin (DXP) in patients with unresectable locally advanced or metastatic gastric cancer. Ann Surg Oncol. 17(4):1024–32.

  6. Ajani JA, Mansfield PF, Crane CH, et al. Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome. J Clin Oncol. 2005;23(6):1237–44.

    Article  PubMed  CAS  Google Scholar 

  7. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11–20.

    Article  PubMed  CAS  Google Scholar 

  8. Sobin LH, Wittekind CH. TNM classification of malignant tumors. 7th ed. International Union Against Cancer (UICC). New York: Wiley, 2009.

    Google Scholar 

  9. Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.

    Article  PubMed  Google Scholar 

  10. Kim HH, Hyung WJ, Cho GS, et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report–a phase III multicenter, prospective, randomized Trial (KLASS Trial). Ann Surg. 251(3):417–20.

  11. Sano T, Sasako M, Yamamoto S, et al. Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended para-aortic lymphadenectomy: Japan Clinical Oncology Group study 9501. J Clin Oncol. 2004;22:2767–73.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011-0011301).

Conflict of interest

The authors have declared no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sung Hoon Noh MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

An, J.Y., Kim, K.M., Kim, Y.M. et al. Surgical Complications in Gastric Cancer Patients Preoperatively Treated with Chemotherapy: Their Risk Factors and Clinical Relevance. Ann Surg Oncol 19, 2452–2458 (2012). https://doi.org/10.1245/s10434-012-2267-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-012-2267-9

Keywords

Navigation