Role of Postoperative Complications in Overall Survival after Radical Resection for Gastric Cancer: A Retrospective Single-Center Analysis of 1107 Patients.

Christian Galata,Christel Weiss,Ulrich Ronellenfitsch,Christoph Reissfelder,Julia Hardt,Susanne Blank

doi:10.3390/cancers11121890

Abstract

Background: The aim of this study was to investigate the impact of postoperative complications on overall survival (OS) after radical resection for gastric cancer. Methods: A retrospective analysis of our institutional database for surgical patients with gastroesophageal malignancies was performed. All consecutive patients who underwent R0 resection for M0 gastric cancer between October 1972 and February 2014 were included. The impact of postoperative complications on OS was evaluated in the entire cohort and in a subgroup after exclusion of 30 day and in-hospital mortality. Results: A total of 1107 patients were included. In the entire cohort, both overall complications (p < 0.001) and major surgical complications (p = 0.003) were significant risk factors for decreased OS in univariable analysis. In multivariable analysis, overall complications were an independent risk factor for decreased OS (p < 0.001). After exclusion of patients with complication-related 30 day and in-hospital mortality, neither major surgical (p = 0.832) nor overall complications (p = 0.198) were significantly associated with decreased OS. Conclusion: In this study, postoperative complications influenced OS due to complication-related early postoperative deaths. In patients successfully rescued from early postoperative complications, neither overall complications nor major surgical complications were risk factors for decreased survival.

Highlights

Even today, surgery for gastric cancer remains challenging, and patients undergoing radical resection are reported to have high complication and failure-to-rescue rates [1,2]
Data of 1107 consecutive patients who underwent R0 resection for M0 gastric cancer at our institution between October 1972 and February 2014 were included in the analysis
This study examined factors associated with overall survival (OS) after radical resection for gastric cancer over a time period of more than four decades in a cohort of 1107 consecutive patients at a European university surgical center

Summary

Introduction

Surgery for gastric cancer remains challenging, and patients undergoing radical resection are reported to have high complication and failure-to-rescue rates [1,2]. Several studies have reported adverse effects of postoperative complications on overall survival (OS) in these patients Such studies have attracted particular interest as they suggest that postoperative complications have a negative impact on oncologic outcomes. A recent systematic review and meta-analysis including 16 retrospective studies found that postoperative complications are correlated with poor prognosis after radical gastrectomy [4]. Thirteen of these studies reported effects of postoperative. The aim of this study was to investigate the impact of postoperative complications on overall survival (OS) after radical resection for gastric cancer. In patients successfully rescued from early postoperative complications, neither overall complications nor major surgical complications were risk factors for decreased survival

Objectives

Methods

Results

Discussion

Conclusion