The Impact of Severe Infectious Complications on Long-term Prognosis for Gastric Cancer

Maezawa, Yukio; Aoyama, Toru; Ju, Mihwa; Komori, Keisuke; Kano, Kazuki; Sawazaki, Sho; Numata, Masakatsu; Hayashi, Tsutomu; Yamada, Takanobu; Sato, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Oshima, Takashi; Yukawa, Norio; Yoshikawa, Takaki; Masuda, Munetaka; Rino, Yasushi

doi:10.21873/anticanres.14404

Cited by 8 publications

(6 citation statements)

References 31 publications

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“…Besides, BMI, pTNM stage and complications were predictive factors for DFS. The results were consisting with previous studies (29,30). Pre-operative lymphocyte was closely associated with human's immune function, and lower level of lymphocyte indicated worse OS in this study (31,32).…”

Section: Cox Regressionsupporting

confidence: 89%

Impact of Preoperative Type 2 Diabetes Mellitus on the Outcomes of Gastric Cancer Patients Following Gastrectomy: A Propensity Score Matching Analysis

et al. 2022

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PurposeThe current study aims to explore the outcomes of type 2 diabetes mellitus (T2DM) on gastric cancer patients following gastrectomy through propensity score matching (PSM) analysis.MethodsA retrospective study of gastric cancer patients following gastrectomy was conducted in a single clinical center from January 2014 to December 2019. The short-term outcomes, overall survival (OS) and disease-free survival (DFS) were analyzed between T2DM group and Non-T2DM group.ResultsA total of 703 patients were enrolled in this study. After 1:1 PSM, 84 patients in T2DM group and 84 patients in Non-T2DM were matched for final analysis. No significant difference was found in terms of operation time, intra-operative blood loss, retrieved lymph nodes, postoperative stay, blood transfusion and complications between T2DM group and Non-T2DM group (p > 0.05). The Kaplan-Meier curve implied that T2DM had no impact on OS or DFS. Cox regression was conducted to identify predictive factors for prognosis. Body mass index (BMI) (p = 0.039 < 0.05, HR = 0.725, 95% CI = 0.534–0.983), pre-operative lymphocyte (p = 0.017 < 0.05, HR = 0.678, 95% CI = 0.493–0.932), pathological tumor node metastasis (pTNM) stage (p = 0.000 < 0.05, HR = 2.619, 95% CI = 2.048–3.349) and complications (p = 0.006 < 0.05, HR = 1.528, 95% CI = 1.132–2.061) were predictive factors for OS, and BMI (p = 0.013 < 0.05, HR = 0.524, 95% CI = 0.315–0.872), pTNM stage (p = 0.000 < 0.05, HR = 2.619, 95% CI = 2.048–3.349) and complications (p = 0.008 < 0.05, HR = 1.892, 95% CI = 1.179–3.036) were independent predictive factors for DFS.ConclusionT2DM did not have an impact on gastric cancer patients following gastrectomy in terms of short-term outcomes and prognosis.

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Section: Cox Regressionsupporting

confidence: 89%

Impact of Preoperative Type 2 Diabetes Mellitus on the Outcomes of Gastric Cancer Patients Following Gastrectomy: A Propensity Score Matching Analysis

et al. 2022

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“…First, change in the NLR was associated with the occurrence of postoperative complications. Recent studies have shown that the occurrence of postoperative complications affects longterm oncological outcomes in various malignancies [18][19][20]. Therefore, the prognosis might have worsened in patients with an increased NLR due to postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Impact of Change in the Neutrophil to Lymphocyte Ratio During the Perioperative Period in Gastric Cancer Patients Who Receive Curative Gastrectomy

Aoyama,

Hashimoto,

Maezawa

et al. 2023

J Gastrointest Canc

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Aim Recently, change in the neutrophil to lymphocyte ratio (cNLR) has been shown to be a promising prognostic inflammation marker in some malignancies. The aim of the present study was to evaluate the clinical impact of the cNLR in gastric cancer patients who received curative gastrectomy. Patients and Methods The present study included 450 patients who underwent curative treatment for gastric cancer between 2013 and 2017 at Kanagawa Cancer Center. The cNLR was defined as follows: cNLR = NLR at 1 month after surgery–NLR at 1 week before surgery. The prognosis and clinicopathological parameters of the increased cNLR and decreased cNLR groups were analyzed. Results The OS stratified by each clinical factor was compared using the log-rank test, and a significant difference was observed using a cutoff value of cNLR at 0.762. When comparing the patient background factors between the increased cNLR (≥ 0.762) and decreased cNLR (< 0.762) groups, there were no significant differences in age, sex, T status, or N status. In the increased cNLR group, the OS rates at 3 and 5 years after surgery were 87.5% and 77.3%, respectively, while those in the decreased cNLR group were 92.8% and 87.3%, which amounted to a statistically significant difference (p = 0.041). The univariate and multivariate analyses of factors associated with OS showed that cNLR was a significant prognostic factor. When the postoperative course was compared between the two groups, the incidence rates of postoperative surgical complications and other-cause death were significantly higher in the increased cNLR group (p = 0.001 and p = 0.005, respectively). Conclusion The cNLR is one of the significant risk factors in gastric cancer patients. Our results suggested that the changes of inflammation status during perioperative periods might be a promising prognostic factor for gastrointestinal cancer patients.

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“…Postoperative intraabdominal infection following radical gastrectomy significantly prolongs hospitalization and healthcare costs [ 10 ] and impairs short-term postoperative survival. [ 11 , 12 ] Moreover, the prolonged inflammatory response it induces has a negative impact on recurrence-free survival and overall survival. [ 13 ] Postoperative infection can also promote tumor recurrence and metastasis.…”

Section: Introductionmentioning

confidence: 99%

A predictive model for intraabdominal infection after radical gastrectomy in elderly patients

Yu,

Tang,

Bai

et al. 2024

Medicine

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Gastric cancer (GC) is one of the most common malignant tumors worldwide and the fourth leading cause of cancer-related deaths, with a relatively high incidence among the elderly population. Surgical resection is the mainstay treatment for GC and is currently the only cure. However, the incidence of postoperative intraabdominal infections remains high and seriously affects the prognosis. This study aimed to explore the risk factors for intraabdominal infections after radical gastrectomy in elderly patients and to establish and validate a risk prediction model. We collected the clinical data of 322 GC patients, who underwent radical gastrectomy at the General Surgery Department of China Medical University Dandong Central Hospital from January 2016 to January 2023. The patients were divided into an infected group (n = 27) and a noninfected group (n = 295) according to whether intraabdominal infections occurred postoperatively. A nomogram risk prediction model for the occurrence of postoperative intraabdominal infections was developed. All patients were randomized into a training set (n = 225) and a validation set (n = 97) in a 7:3 ratio, and the model was internally validated. Of the 322 patients, 27 (8.3%) experienced postoperative intraabdominal infections. Single-factor analysis revealed associations of intraabdominal infection with body mass index, glucose, hemoglobin, albumin, and other factors. The multifactorial analysis confirmed that body mass index, glucose, hemoglobin, albumin, surgical duration, and bleeding volume were independent risk factors for intraabdominal infections. The nomogram constructed based on these factors demonstrated excellent performance in both the training and validation sets. A nomogram model was developed and validated to predict the risk of intraabdominal infection after radical gastrectomy. The model has a good predictive performance, which could help clinicians prevent the occurrence of intraabdominal infections after radical gastrectomy in elderly patients.

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The Impact of Severe Infectious Complications on Long-term Prognosis for Gastric Cancer

Abstract: Background: The aim of this study was to evaluate the impact of postoperative infectious complications on longterm outcomes after curative resection of gastric cancer. Patients and Methods: Patients who underwent curative gastrectomy with lymphadenectomy for gastric cancer at

Cited by 8 publications

References 31 publications

Impact of Preoperative Type 2 Diabetes Mellitus on the Outcomes of Gastric Cancer Patients Following Gastrectomy: A Propensity Score Matching Analysis

Impact of Preoperative Type 2 Diabetes Mellitus on the Outcomes of Gastric Cancer Patients Following Gastrectomy: A Propensity Score Matching Analysis

The Clinical Impact of Change in the Neutrophil to Lymphocyte Ratio During the Perioperative Period in Gastric Cancer Patients Who Receive Curative Gastrectomy

A predictive model for intraabdominal infection after radical gastrectomy in elderly patients

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