Morbidity and mortality according to age following gastrectomy for gastric cancer

Nelen, S. D.; Bosscha, K.; Lemmens, Valery; Hartgrink, Henk H.; Verhoeven, Rob H.A.; Wilt, Johannes de

doi:10.1002/bjs.10836

Cited by 41 publications

(40 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Older patients are expected to have more complications, as a consequence of a decline in performance status. Different cut‐offs for age have been used in the literature, as in a Dutch cohort that showed a higher risk of complications among patients over 70‐year old . We opted not to use cut‐offs and to keep “age” as a continuous variable in our study to improve statistical power.…”

Section: Discussionmentioning

confidence: 99%

“…These variables were age, 5,17 COPD, 18 CHD, 2 chronic liver disease, 12 CCI, 19 ASA classification, 11 pancreas and spleen resection, 2,17 blood transfusion 20 , and extent of resection. 2,5 All the other variables described in Section 2.2 were analyzed then, following a stepwise selection algorithm, with different significance levels to entry (0.10) and stay (0.05). Variables were removed from the model if they were nonsignificant and did not act as confounders (change in β coefficient >20%).…”

Section: Discussionmentioning

confidence: 99%

“…For model building, a group of 10 variables was initially forced into the model, based on prior knowledge of their impact on the outcomes. These variables were age, COPD, CHD, chronic liver disease, CCI, ASA classification, pancreas and spleen resection, blood transfusion, and extent of resection . All the other variables described in Section were analyzed then, following a stepwise selection algorithm, with different significance levels to entry (0.10) and stay (0.05).…”

Section: Methodsmentioning

confidence: 99%

“…In a large series of patients including both total and distal resections, morbidity has ranged between 18% and 37%, and mortality between 0.6% and 4.7%. 1,2 Results from Western randomized trials have improved over time, with postoperative mortality decreasing from over 10% in the older D2-lymphadenectomy trials 3,4 to approximately 5% in the recent Critics trial, 5 which still remains high when compared to results from Asian trials. 6 Postoperative complications impact patients' oncologic outcomes and have been associated with impaired survival in esophageal 7 and gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

Background Postoperative complications after gastric cancer resection vary in different series and they might have a significant impact in long‐term outcomes. Our aim was to build a prediction rule on gastric cancer patients' overall and major morbidity risks. Methods This retrospective study included 1223 patients from a single center who were resected between 1992 and 2016. Overall and major morbidity predictors were identified through multiple logistic regression. Models' performances were assessed through discrimination, calibration, and cross‐validation, and nomograms were constructed. Results The mean age was 61.3‐year old and the male gender was more frequent (60%). The most common comorbidities were hypertension (HTN), diabetes, and chronic obstructive pulmonary disease (COPD). A D2‐distal gastrectomy was the most frequent procedure and 87% of all lesions were located in the middle or distal third. Age, COPD, coronary heart disease, chronic liver disease, pancreatic resection, and operative time were independent predictors of overall and major morbidity. The extent of resection and splenectomy was associated with overall events and HTN with major ones. Both models were very effective in predicting events among patients at higher risk. Conclusions The overall and major morbidity models and nomograms included clinical‐ and surgical‐related data that were very effective in predicting events, especially for high‐risk patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

“…Moreover, a small proportion of the patients may have had surgery with palliative intent. Based on a previous study, this percentage would be approximately 4·3 per cent. However, excluding these patients from the analysis was impossible as no information about the intention of surgery was available in the NCR.…”

Section: Discussionmentioning

confidence: 99%

Overall survival before and after centralization of gastric cancer surgery in the Netherlands

Putten

Nelen

Lemmens

et al. 2018

British Journal of Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Risk factors for serious postoperative complications following gastrectomy in super‐elderly patients ≥85‐years‐old with gastric cancer: A National Clinical Database study in Japan

Ueda,

Nishimura,

Inomata

et al. 2024

Annals of Gastroent Surgery

View full text Add to dashboard Cite

AimThis study aimed to evaluate the technical safety and feasibility of gastrectomy for super‐elderly patients ≥85‐y‐old with gastric cancer and to clarify the risk factors for serious postoperative complications in these patients.MethodsBetween 2017 and 2020, 10,203 patients who underwent distal gastrectomy (DG) and 2580 patients who underwent total gastrectomy (TG) were reviewed from the Japanese National Clinical Database. All possible preoperative factors were used to explore the risk factors for serious postoperative complications in the super‐elderly patients with gastric cancer.ResultsFor DG, the operative mortality rate was 1.6% (162 patients), and the rate of serious postoperative complications was 7.8% (796 patients). Similarly, the mortality rate was 2.6% (67 patients), and the rate of serious complications was 11.3% (292 patients) for TG. Based on multivariate analysis, body mass index (≥25 kg/m2), activities of daily living (ADL) (partially dependent), ASA‐PS (Grade ≥3), dyspnea, ascites, history of cerebrovascular disease, serum albumin (<4 g/dL), and creatinine (>1.2 mg/dL) in DG, and ADL (partially dependent), ASA‐PS (Grade ≥3), previous percutaneous coronary intervention, dialysis, WBC (>9000 μL), and AST (>35 IU/L) in TG were strong risk factors for serious postoperative complications.ConclusionsThe study findings suggest that gastrectomy for super‐elderly gastric cancer patients is relatively safe and feasible. Surgeons need to pay special attention to physical status and past medical history than tumor factors for preventing serious postoperative complications in super‐elderly gastric cancer patients.

show abstract

Morbidity and mortality according to age following gastrectomy for gastric cancer

Abstract: ASA grade, neoadjuvant chemotherapy and type of resection are independent predictors of morbidity and death in patients with gastric cancer, irrespective of age.

Cited by 41 publications

References 33 publications

Predicting overall and major postoperative morbidity in gastric cancer patients

Predicting overall and major postoperative morbidity in gastric cancer patients

Overall survival before and after centralization of gastric cancer surgery in the Netherlands

Risk factors for serious postoperative complications following gastrectomy in super‐elderly patients ≥85‐years‐old with gastric cancer: A National Clinical Database study in Japan

Contact Info

Product

Resources

About