Open AccessMulti‐institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer
Author(s) -
Kanda Mitsuro,
Ito Seiji,
Mochizuki Yoshinari,
Teramoto Hitoshi,
Ishigure Kiyoshi,
Murai Toshifumi,
Asada Takahiro,
Ishiyama Akiharu,
Matsushita Hidenobu,
Tanaka Chie,
Kobayashi Daisuke,
Fujiwara Michitaka,
Murotani Kenta,
Kodera Yasuhiro
Publication year - 2019
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.2439
Subject(s) - medicine , surgery , pathological , chemotherapy , cancer , stage (stratigraphy) , abscess , anastomosis , retrospective cohort study , adjuvant chemotherapy , clinical significance , complication , paleontology , breast cancer , biology
Background Insufficient data are available on the prognostic significance of complications after resection of gastric cancer. Therefore, we aimed to assess this gap in our knowledge by studying patients with resectable gastric cancer. Methods A multi‐institutional retrospective database comprising clinical information of 3575 patients who received resection of gastric cancer from 2010 to 2014 at nine institutions. Grades 2 or greater complications of the Clavien‐Dindo classification were judged as clinically relevant postoperative complications, and their associations with postoperative survival were assessed. We assessed the effect of complications on times of initiation and continuation of postoperative adjuvant chemotherapy by S‐1. Results A total of 2954 patients were included in the analysis. Clinically relevant postoperative complications occurred in 664 (23%) patients. Patients’ recurrence‐free survival rate incrementally decreased as the grade of complications became greater. Patients with abdominal complications (eg, leakage of pancreatic fluids, intra‐abdominal abscess, and anastomotic leakage) and those with nonabdominal complications (eg, pneumonia) experienced worse recurrence‐free survival compared to those without complications. Patients who had complications were generally at greater risk of disease recurrence, except for those who underwent laparoscopic surgery and those with pathological stage I. Delayed initiation and shorter continuation of adjuvant S‐1 chemotherapy was experienced by patients with postoperative complications. Conclusions Postoperative complications adversely affected the prognosis in patients with resectable gastric cancer.