Impact of preoperative risk factors on outcome after gastrectomy

Eichelmann, Ann-Kathrin; Saidi, Meltem; Lindner, Kirsten; Lenschow, Christina; Palmes, Daniel; Pascher, Andreas; Hummel, Richard

doi:10.1186/s12957-020-1790-6

Cited by 9 publications

(3 citation statements)

References 33 publications

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“…Even with additional radiological modalities of CT, EUS and PET CT, nodal size did not predict lymph node metastasis in oesophageal cancer 24 . Pre-operative risk prediction for morbidity severity is also limited, with contradictory results reported related to POSSUM and O-POSSUM 25,26 . Nevertheless, this scoring system has potential in patients receiving primary surgery (uni-modal therapy), who might subsequently be candidates for adjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

Powell

Coxon

Robinson

et al. 2020

Preprint

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Objective: Survival after gastric cancer surgery is largely attributed to tumor biology, neoadjuvant chemotherapy (NAC), and surgical approach, yet other prognostic factors have been reported, including pre-operative systemic inflammatory response (SIR), and Morbidity Severity Score (MSS). The hypothesis tested was that a SIR, MMS, and pathological composite score, would be associated with disease-free (DFS) and overall survival (OS). Methods: Consecutive 358 patients undergoing potentially curative gastrectomy for adenocarcinoma were studied. Complications were defined as a MSS of Clavien-Dindo classification (CDSC) >1. Serum SIR measurements were performed on the day before surgery, and a composite score (CIMpN) (0-3) was developed based on CRP, morbidity, and pN-stage. Primary outcome measures were DFS and OS. Results: Post-operative complications occurred in 138 (38.5%) patients, (8 (2.2%) deaths), and was associated with higher CRP (28.3% vs. 15.5%, p=0.003), vascular invasion (55.8% vs. 36.8%, p<0.001), and R1 status (26.1% vs. 9.5%, p=0.001). Five-year DFS and OS were 32.9% and 33.3% for patients with post-operative complications compared with 62.5% and 64.0% in controls (p<0.001). Five-year DFS and OS were 31.4% and 37.3% in patients with raised CRPs compared with 58.5% and 59.5% in controls (p=0.005, p=0.001, respectively). Five-year DFS for CIMpN scores of 0, 1, 2, and 3 were 85.9%, 50.0%, 26.2%, and 15.4% (p<0.001) respectively. On multivariable analysis CIMpN score was independently associated with DFS [HR 3.00, 95% Confidence Interval (CI) 1.90-4.73, p<0.001] and OS [1.93 (1.43-2.59), p<0.001]. Conclusion: A novel composite score, CIMpN, based on SIR, MSS and pN-stage, offers important prognostic signals.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

Powell

Coxon

Robinson

et al. 2020

Preprint

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“…Postoperative complications adversely affect the long-term survival of patients with gastric cancer. Therefore, the risk factors of postoperative complications should be identified and postoperative complication rates reduced [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Trunk fat volume can be a predictor of postoperative complications after gastrectomy: a retrospective cohort study

et al. 2021

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Background Obesity can affect postoperative outcomes of gastrectomy. Visceral fat area is superior to body mass index in predicting postoperative complications. However, visceral fat area measurement is time-consuming and is not optimum for clinical use. Meanwhile, trunk fat volume (TFV) can be easily measured via bioelectrical impedance analysis. Hence, the current study aimed to determine the ability of TFV to predict the occurrence of complications after gastrectomy. Methods We retrospectively reviewed patients who underwent curative gastrectomy for gastric cancer between November 2016 and November 2019. The trunk fat volume-to-the ideal amount (%TFV) ratio was obtained using InBody 770 before surgery. The patients were classified into the obese and nonobese groups according to %TFV (TFV-H group, ≥ 150%; TFV-L group, < 150%) and body mass index (BMI-H group, ≥ 25 kg/m2; BMI-L group, < 25 kg/m2). We compared the short-term postoperative outcomes (e.g., operative time, blood loss volume, number of resected lymph nodes, and duration of hospital stay) between the obese and nonobese patients. Risk factors for complications were assessed using logistic regression analysis. Results In total, 232 patients were included in this study. The TFV-H and BMI-H groups had a significantly longer operative time than the TFV-L (p = 0.022) and BMI-L groups (p = 0.006). Moreover, the TFV-H group had a significantly higher complication rate (p = 0.004) and a lower number of resected lymph nodes (p < 0.001) than the TFV-L group. In the univariate analysis, %TFV ≥ 150, total or proximal gastrectomy, and open gastrectomy were found to be potentially associated with higher complication rates (p < 0.1 for all). Moreover, the multivariate analysis revealed that %TFV ≥ 150 (OR: 2.73; 95% CI: 1.37–5.46; p = 0.005) and total or proximal gastrectomy (OR: 3.57; 95% CI: 1.79–7.12; p < 0.001) were independently correlated with postoperative morbidity. Conclusions %TFV independently affected postoperative complications. Hence, it may be a useful parameter for the evaluation of obesity and a predictor of complications after gastrectomy.

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“…Postoperative complications adversely affect the long-term survival of patients with gastric cancer. Therefore, the risk factors of postoperative complications should be identi ed and postoperative complication rates reduced [2].…”

mentioning

confidence: 99%

Trunk Fat Volume Can Be a Predictor of Short-Term Surgical Outcomes After Gastrectomy: A Retrospective Cohort Study

Shiomi

Toriumi

Yagi

et al. 2021

Preprint

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Background Obesity can affect postoperative outcomes of gastrectomy. Visceral fat area is superior to body mass index in predicting postoperative complications. However, visceral fat area measurement is time-consuming and is not optimum for clinical use. Meanwhile, trunk fat volume (TFV) can be easily measured via bioelectrical impedance analysis. Hence, this current study aimed to determine the association of trunk fat volume in predicting the occurrence of complications after gastrectomy. Methods We retrospectively reviewed patients who underwent curative gastrectomy for gastric cancer between November 2016 and November 2019. The trunk fat volume-to-the ideal amount (%TFV) ratio was obtained using InBody 770 before surgery. The patients were classified into the obese and nonobese groups according to %TFV (TFV-H group, ≥ 150 %; TFV-L group, < 150 %) and body mass index (BMI-H group, ≥ 25 kg/m2; BMI-L group, < 25 kg/m2). We compared the short-term postoperative outcomes (e.g., operative time, blood loss volume, number of resected lymph nodes, and duration of hospital stay) between the obese and nonobese patients. Risk factors for complications were assessed using logistic regression analysis. Results In total, 232 patients were included in this study. The TFV-H and BMI-H groups had a significantly longer operative time than the TFV-L (p = 0.022) and BMI-L groups (p = 0.006). Moreover, the TFV-H group had a significantly higher complication rate (p = 0.004) and a lower number of resected lymph nodes (p < 0.001) than the TFV-L group. In univariate analysis, %TFV ≥ 150, total or proximal gastrectomy, and open gastrectomy were found to be potentially associated with higher complication rates with p values < 0.1. Meanwhile, multivariate analysis revealed that %TFV ≥ 150 (OR: 2.73; 95%CI: 1.37–5.46; p = 0.005) and total or proximal gastrectomy (OR: 3.57; 95%CI: 1.79–7.12; p < 0.001) were independently correlated with postoperative morbidity. Conclusions %TFV independently affected postoperative complications. Hence, it may be a useful parameter for the evaluation of obesity and a predictor of short-term surgical outcomes after gastrectomy.

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Impact of preoperative risk factors on outcome after gastrectomy

Cited by 9 publications

References 33 publications

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

Prognostic significance of compound combined peri-operative biomarkers in gastric cancer

Trunk fat volume can be a predictor of postoperative complications after gastrectomy: a retrospective cohort study

Trunk Fat Volume Can Be a Predictor of Short-Term Surgical Outcomes After Gastrectomy: A Retrospective Cohort Study

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