Safety of prolonged wait time for gastrectomy in clinical stage I gastric cancer

Fujiya, Keiichi; Irino, Tomoyuki; Furukawa, Katsunori; Omori, Hayato; Makuuchi, Rie; Takeda, Yutaka; Bando, Etsuro; Terashima, Masanori

doi:10.1016/j.ejso.2019.06.006

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…The average progression time from localized to locally evolved or metastatic is 34-44 months, based on Asian literature data. The doubling time of a locally advanced gastric cancer is 6.2 months [17,18]. The epidemiology of oesogastric cancers in France and in Europe are different, so that these data need to be analysed with some clinical circumspection.…”

Section: Oncological Impact Of Deferralmentioning

confidence: 99%

Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

Tuech

Gangloff

Fiore

et al. 2020

Journal of Visceral Surgery

132

145

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Introduction: The Coronavirus disease-2019 (COVID-19) pandemic is a global health crisis and surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on prevalent general surgical practice is uncertain and continues to evolve. Aims/Objectives: To study the impact of COVID-19 on general surgical practice in India and the future implications of the pandemic. Methods: A survey questionnaire was designed and electronically circulated one month after India entered a national lockdown during covid-19 pandemic, among members of Indian Association of Gastro-intestinal Endosurgeons (IAGES), a surgical association with nearly eight thousand members. Survey questions pertaining to pre-COVID era surgical practices, impact on current practice and nancial implications were asked. Responses were collected and statistically analyzed. Results: 153 surgeons completed the survey, of which only 9.2% were females. 41% surgeons were more than 20 years into practice. 36.6% were into private practice at multiple hospitals (free-lancers). 41.8% had mainly laparoscopic practice with mean outpatient consultation of 26 patients/day and elective surgeries of 43 cases /month prior to lockdown. Post lock-down, daily outpatient consults reduced to 4 patients/day and 77% had not performed even a single elective procedure. 52% were taking hydroxychloroquine (HCQ) as chemoprophylaxis. 56.9% stated they are using personal protective equipment for all cases while 71.5% stated there are insu cient guidelines for future surgical practice in terms of safety. 52% surgeons stated a drop of more than 75% of their monthly income while 22% faced 50-75% reduction. 33% of respondents own a hospital and are expecting a monthly nancial liability of 2.25 Million rupees (nearly 30,000 US dollars). Conclusion: COVID 19 has led to a drastic reduction in outpatient and elective surgical practices. There is a de nite need for guidelines regarding safety for future surgical practices and solutions to overcome the nancial liabilities in the near future.

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Section: Oncological Impact Of Deferralmentioning

confidence: 99%

Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

Tuech

Gangloff

Fiore

et al. 2020

Journal of Visceral Surgery

132

145

View full text Add to dashboard Cite

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“…The doubling time of a locally advanced GC is 6.2 months. 41,42 Since these data come from Asian countries, they need to be interpreted with caution in other parts of the world.…”

Section: Strategy For the Treatment Of Gc During The Covid-19 Pandemicmentioning

confidence: 99%

<p>Treatment of Gastric Cancer Patients During COVID-19 Pandemic: The West is More Vulnerable</p>

Polkowski¹,

Sędłak²,

Rawicz‐Pruszyński³

2020

CMAR

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The outbreak of the COVID-19 is currently the biggest international concern. Treatment of gastric cancer (GC) patients in the pandemic era with high hospital burden and under severe oncological/surgical resource constraints should implicate a need for resource reallocation with a new "pandemic" GC treatment algorithm. The neoadjuvant/perioperative (radio-)chemotherapy is applied in the majority of advanced GC cases with poor postoperative therapy compliance. In the East, radical surgery is frequently used in the first instance, with adjuvant chemotherapy reserved for patients with a high risk of recurrence. Moreover, the elderly population might be effectively treated by surgery alone, thus saving oncological resources for younger people who need a more aggressive approach. In this framework, prioritization is a key concept based on the severity of symptoms and the need for urgent (surgical) intervention. High-risk and marginally effective surgery should be replaced with definitive radio-and/or chemotherapy. The pandemic framework to provide optimal care for GC patients must be based on multidisciplinary decision-making and include all anti-cancer treatment options: surgery, systemic therapy, and radiotherapy. The priority and staffing dictate adherence to the new algorithm. We believe that these priorities may improve the delivery of care to all, including elderly GC patients.

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“…The cause of the shorter postoperative hospital stays of the long-waiting group remained unclear, and adequate preoperative preparation might shorten the postoperative hospital stay. 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.…”

Section: Discussionmentioning

confidence: 62%

“…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%

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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Safety of prolonged wait time for gastrectomy in clinical stage I gastric cancer

Cited by 20 publications

References 19 publications

Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

Strategy for the practice of digestive and oncological surgery during the Covid-19 epidemic

<p>Treatment of Gastric Cancer Patients During COVID-19 Pandemic: The West is More Vulnerable</p>

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

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