Surgical resection remains the gold standard treatment for gastric cancer; however, the rate of post-operative complications remains unsatisfactory. Although the majority of complications are treatable, it remains unknown whether the long-term survival of patients is affected and what type of complications affect prognosis. In the present study, the modified Clavien-Dindo classification system was used to examine the incidence of early complications along with the related risk factors following radical gastrectomy (RG) and to determine the effects of such complications on long-term prognosis. For this purpose, 525 gastric cancer patients with RG were analyzed retrospectively. The results revealed that age [odds ratio (OR), 1.781; P=0.013], pre-operative comorbidity (OR, 1.765; P=0.020), blood loss (OR, 2.153; P=0.001) and the type of surgery (OR, 3.137; P<0.001) were identified as independent risk factors associated with post-surgery complications. Blood loss (OR, 13.053; P=0.013) and the resection type (OR, 7.936; P= 0.047) were identified as independent risk factors for severe complications. The 5-year overall survival (OS) rate of patients in the severe complication group was 35%, which was significantly worse than that of patients in the non-severe complication group (61.8%). Severe complications (hazard ratio, 1.595; P=0.107) were not found to be independent risk factors associated with the 5-year OS. On the whole, the present study demonstrates that complications following RG were significantly related to age, pre-operative comorbidity, blood loss and the type of surgery. Severe complications were distinctly affected by blood loss and the resection type. The 5-year OS of patients in the severe complication group was significantly worse than that of patients in the non-severe complication group; however, severe complications were not found to be independent risk factors associated with long-term survival.

Background The modified Clavien-Dindo classification system was employed to investigate the occurrence of early complications along with the related risk factors following a radical gastrectomy procedure, with the view of conducting an analysis into the impact of complications on long-term prognosis. Methods The clinical data of 525 patients who had previously undergone a radical gastrectomy procedure for gastric cancer were analyzed in a retrospective fashion. Results Postoperative hospital stay: Complication group (17.88±8.472) days, severe complications group (23.10±7.594) days, significantly higher than non-complication group (10.26±1.973) days and non-severe complications group (11.47±4.712) days (P=0.000<0.05).Multivariate analysis: age (OR = 1.781, P = 0.013), preoperative comorbidity (OR = 1.765, P = 0.020), blood loss (OR = 2.153, P = 0.001), surgical approach (OR = 3.137, P = 0.000) were identified as an independent risk factor associated with early complications. Blood loss (OR=13.053, P=0.013), type of resection (OR=7.936, P=0.047) and nerve involvement (OR=3.670, P=0.009) were identified to be independent risk factors for severe complications.Severe postoperative complications (HR=1.595, P=0.107) and postoperative complications (HR=1.078, P=0.670) were not independent risk factors affecting the 5-year over survival rate. Conclusion Complications following radical gastrectomy were closely related to age, preoperative comorbidity, blood loss, and surgical approach; severe complications were closely related to blood loss, total gastrectomy, and nerve involvement; complications and severe complications were not found to be independent risk factors associated with long-term survival, that being said, they were significantly prolonged postoperative hospital stay.