Impact of preoperative wait time on survival in patients with clinical stage II/III gastric cancer

Furukawa, Katsunori; Irino, Tomoyuki; Makuuchi, Rie; Koseki, Yusuke; Nakamura, Kenichi; Waki, Yuhei; Fujiya, Keiichi; Omori, Hayato; Takeda, Yutaka; Bando, Etsuro; Kawamura, Taiichi; Terashima, Masanori

doi:10.1007/s10120-018-00910-y

Cited by 25 publications

(24 citation statements)

References 26 publications

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“…Previous studies reported than a half-year wait time for surgery was not independently associated with the survival of patients with clinical stage I gastric cancer, 13 and a preoperative wait time up to 90 days did not affect survival in patients with clinical stage II/III gastric cancer. 14 The results in this study were consistent with previous studies. However, delayed gastrectomy is not recommended because of the preoperative waiting timerelated psychological distress and displeasure.…”

Section: Discussionsupporting

confidence: 93%

“…However, as previously described, a waiting time beyond more than 90 days before surgery would not affect overall survival in patients with clinical stages I, II and III. [13][14][15] Previous studies have proven that the birth season may affect the incidence of tumors, and furthermore, tumors diagnosed in winter may affect the prognosis as well. 16,17 However, one study reported that the diagnosis season did not affect the prognosis of gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

Peng

Zou

Cheng

et al. 2021

RMHP

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The purpose of the present study was to evaluate the effect of time (season, surgical starting time in the daytime, preoperative waiting time) on patients with gastric cancer. Methods: A retrospective collection of medical records of patients who underwent gastrectomy at a single clinical center from January 2013 to December 2018 was performed. Medical records were collected, and short-term outcomes and long-term survival were analyzed by different time groups. Results: A total of 586 patients were included in this study. In terms of surgical starting time, the midday group had a shorter operation time (p=0.017) but more complications (p=0.048) than the non-midday group. No significant difference was found based on the season of gastrectomy. The long preoperative waiting group had a shorter postoperative hospital stay than the short waiting group (p=0.026). No significant difference was found between the short-waiting group and long-waiting group in overall survival for all clinical stages. Age (p=0.040, HR=1.017, 95% CI=1.001-1.033), BMI (p<0.001, HR=0.879, 95% CI=0.844-0.953) and clinical stage (p<0.001, HR=2.053, 95% CI=1.619-2.603) were independent prognostic factors predicting overall survival; however, season of gastrectomy, surgical starting time and preoperative waiting time were not identified as independent prognostic factors. Conclusion: Surgical starting time at the midday could cause more complications, and surgeons should be careful when the surgical starting time is midday.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

Peng

Zou

Cheng

et al. 2021

RMHP

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“…When we conduct preoperative interventions, there is a concern about tumor progression, particularly in patients with advanced cancer. However, preoperative wait time up to 90 days has been reported not to affect survival even in cStage / gastric cancer patients [30]. Hence, obese patients might have the bene ts of fewer complications by preoperative exercise.…”

Section: Discussionmentioning

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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“…These facts cannot be overseen, also, cancer is a bigger problem than COVID-19 from patient's perspective. Table 1 summarises various studies addressing the impact of time to treatment initiation or delaying surgeries on cancer survival [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. Keeping these concerns in mind, some guidelines have recommended a possible triage ( Table 2) to offer surgeries, even during the course of an active pandemic, for certain precarious malignancies who are known to have rapid progression.…”

Section: Cancer Surgery In Covid-19 Outbreakmentioning

confidence: 99%

To Do or Not to Do?—A Review of Cancer Surgery Triage Guidelines in COVID-19 Pandemic

Shinde

Naik

Shinde

et al. 2020

Indian J Surg Oncol

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COVID-19 pandemic has emerged as a global health emergency involving more than 200 countries so far. The number of affected population is on rising, so is the mortality. This crisis has overwhelmed the healthcare infrastructures in many affected countries. Due to overall rising cancer incidence and specific concerns, a cohort of cancer patients forms a distinct subset of the population in whom a correct and timely treatment has a huge impact on the outcome. During this period, oncology care is definitely affected owing to many factors like lockdowns, reduced beds and deferral of elective cases to halt the spread of the pandemic. Surgery remains the best line of defence in many solid organ tumours especially in early stage and is potentially curative. China, the source of this pandemic, has taken more than 3 months to enter the post transitional phase of this pandemic. Deferring cancer surgeries for this long period may have a direct impact on the long-term outcomes of cancer patients. Many surgical oncology associations across the globe have come up with triage guidelines for surgical care of cancer patients; however, these are based on expert opinion rather than actual data. Herein, we intend to review these guidelines with respect to the risk of disease progression in cancer patients. In the absence of actual data on cancer surgery care during this pandemic, clinical decisions should be based on careful consideration of disease-related and patient-related factors. While some of the cancer surgeries can be safely delayed for some time, how long we can delay surgeries safely cannot be answered/ explained by any means. Thorough evaluation and discussion by an expert and experienced multidisciplinary team appears to be the most effective way forward.

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Impact of preoperative wait time on survival in patients with clinical stage II/III gastric cancer

Cited by 25 publications

References 26 publications

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

Effect of Time (Season, Surgical Starting Time, Waiting Time) on Patients with Gastric Cancer

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

To Do or Not to Do?—A Review of Cancer Surgery Triage Guidelines in COVID-19 Pandemic

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