Risk Factors and Prognostic Impact of Postoperative Complications in Patients with Advanced Gastric Cancer Receiving Neoadjuvant Chemotherapy

Abstract

Background: Neoadjuvant chemotherapy is important to improve the prognosis of patients with advanced gastric cancer. However, it may result in postoperative complications (POCs). The aim of this study is to evaluate risk factors and prognostic impact of POCs in patients receiving neoadjuvant chemotherapy. Methods: We retrospectively collected clinical information of patients who underwent curative gastrectomy after receiving neoadjuvant chemotherapy between 2011 and 2018. Overall survival (OS) was analyzed using the Kaplan–Meier method. Logistic regression and Fisher’s exact test were used to evaluate risk factors for complications. Results: A total of 176 patients were included in our study. The 3-year OS rates for the complication group (n = 30) and non-complication group (n = 146) were 36.7% and 52.7%, respectively (p = 0.0294). Age, BMI, multivisceral resection and operation time were independent risk factors for POCs in patients. Patients with multivisceral resection were more likely to suffer from grade III-IV complications (p =0.026). Inflammation complications might occur in patients with high BMI (p = 0.017). Low preoperative albumin seemed to be a risk factor for leakage complications (p = 0.033). Conclusions: Our study revealed that patients with POCs had a poor prognosis and we identified the risk factors for complications so that POCs can be avoided in time.

Can the Pathological Response in Patients with Locally Advanced Gastric Cancer Receiving Neoadjuvant Treatment Be Predicted by the CEA/Albumin and CRP/Albumin Ratios?

“…Few studies have investigated the use of preoperative parameters such as albumin levels to predict the risk of postoperative recurrence and complications in patients undergoing neoadjuvant therapy [24]. Yu et al [25] found that low preoperative albumin levels were a risk factor (p = 0.033) for postoperative complications in patients undergoing curative gastrectomy after neoadjuvant chemotherapy, while Migita et al [14] found a correlation between decreased serum albumin levels after neoadjuvant therapy and survival rate.…”

Safety and feasibility of minimally invasive gastrectomy after neoadjuvant immunotherapy for locally advanced gastric cancer: a propensity score-matched analysis in China

“…Post-operative recovery and complications are crucial indices of short-term safety and efficacy. Neoadjuvant therapy can increase the incidence of myelosuppression and malnutrition, decrease immune function, and aggravate tissue edema, fibrosis, and chronic inflammation, further increasing structural complexity, all of which can increase the risk of poor surgical safety and POCs [ 35 ]. Hong et al [ 36 ] reported that esophagectomy was safe and feasible following NICT for locally advanced esophageal cancer.…”

An unusual non‑metastatic, mismatch repair‑deficient primary gastric squamous cell carcinoma presenting as a large, exophytic, bleeding tumor: A case report

“…Cancer is a global health problem and the second leading cause of death in developed countries ( 1 ). A significant part of that problem is gastric cancer, being the fifth most common cancer worldwide ( 2 ). Despite numerous improvements in systemic treatment, patients diagnosed at an advanced stage have poor prognosis ( 3 ), and in such cases, medical procedures may be more of a palliative nature ( 4 ).…”