Short-term outcomes of gastrectomy after neoadjuvant chemotherapy for clinical stage III gastric cancer: propensity score-matched analysis of a multi-institutional database.

Abstract

PURPOSE:

Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy.

METHODS:

We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014. Patients with clinical stage-III gastric adenocarcinoma were divided into a neoadjuvant chemotherapy (NAC) group and a non-NAC group. We performed propensity-matched comparative analysis to stratify the groups according to age, sex, tumor region, tumor type, preoperative stage, procedure, lymph node dissection, and tumor differentiation. Preoperative blood data, surgical findings, and postoperative complications were analyzed.

RESULTS:

Analysis of the matched NAC (n = 64) and non-NAC (n = 128) groups revealed that the preoperative values of neutrophils, platelets, and Hb were significantly lower in the NAC group. Blood loss during surgery was significantly higher, surgical times were longer, and the rate of repeat surgery was significantly lower in the NAC group; however, the rates of rehospitalization did not differ between the groups and mortality was 0% in both groups. Postoperative complications were not significantly different between the groups.

CONCLUSIONS:

NAC did not increase the complication rate of gastrectomy for gastric cancer.

• Authors: Shinichi Umeda, Mitsuro Kanda, Koki Nakanishi, Seiji Ito, Yoshinari Mochizuki, Hitoshi Teramoto, Kiyoshi Ishigure, Toshifumi Murai, Takahiro Asada, Akiharu Ishiyama, Hidenobu Matsushita, Dai Shimizu, Daisuke Kobayashi, Chie Tanaka, Michitaka Fujiwara, Kenta Murotani, Yasuhiro Kodera
• Journal: Surgery today (Surg Today) Vol. 51 Issue 5 Pg. 821-828 (May 2021) ISSN: 1436-2813 [Electronic] Japan
• PMID: 33170366 (Publication Type: Comparative Study, Journal Article)

Topics

• Databases, Factual
• Female
• Gastrectomy (methods)
• Humans
• Male
• Multicenter Studies as Topic
• Neoadjuvant Therapy (methods)
• Neoplasm Staging
• Postoperative Complications (epidemiology)
• Propensity Score
• Stomach Neoplasms (pathology, surgery)
• Time Factors
• Treatment Outcome