Impact of Minimally Invasive Gastrectomy on Use of and Time to Adjuvant Chemotherapy for Gastric Adenocarcinoma

Overview

Journal J Surg Oncol

Specialties General Surgery
Oncology

Date 2020 Jan 11

PMID 31919862

Citations 5

Authors

Norma E Farrow

Kyle W Freischlag

Mohamed A Adam

Dan G Blazer

Affiliations

Soon will be listed here.

Abstract

Background: Chemotherapy improves outcomes in patients with resectable gastric cancer. Minimally invasive gastrectomy (MIS) rates are increasing, though the impact of MIS on postoperative chemotherapy remains uncertain. This study examines the impact of MIS vs open gastrectomy (OG) on utilization of adjuvant chemotherapy for high-risk gastric cancer.

Methods: Patients in the National Cancer Database who underwent resection for high-risk gastric adenocarcinoma between 2010 and 2015 were included. Patients were stratified by surgical approach (MIS vs OG) and analyzed using multivariable regression modeling. Primary endpoints were utilization of and time to initiation of adjuvant chemotherapy.

Results: Overall, 23 071 patients were included; 16 595 (71.9%) underwent OG and 6476 (28.1%) underwent MIS. After adjusting for patient and tumor characteristics, MIS was not associated with increased use of adjuvant chemotherapy (odds ratio [OR]: 1.027, 95% confidence interval [CI]: 0.95 to 1.11, P = .50), and time to initiation of chemotherapy was similar (-2% change, 95% CI: -5% to +1%, P = .27). MIS was associated with shorter hospital stays (-1 day). Thirty-day readmission rates, 90-day mortality, and overall survival were similar between groups.

Conclusions: In this study, while MIS for gastric adenocarcinoma was associated with shorter hospital stays and comparable survival, it was not associated with improved utilization or time to initiation of adjuvant chemotherapy.

Citing Articles

ASO Author Reflections: Enhancing Return to Intended Oncologic Therapy in Gastric Cancer-The Role of Minimally Invasive Gastrectomy.

Mavani P, Koo A, Kooby D, Shah M Ann Surg Oncol. 2024; 32(2):1257-1258.

PMID: 39556175 PMC: 11710969. DOI: 10.1245/s10434-024-16517-w.

Effect of Minimally Invasive Gastrectomy on Return to Intended Oncologic Therapy for Gastric Cancer.

Koo A, Mavani P, Sok C, Goyal S, Concors S, Mason M Ann Surg Oncol. 2024; 32(1):230-239.

PMID: 39516415 PMC: 11663121. DOI: 10.1245/s10434-024-16440-0.

Impact of Laparoscopic Gastrectomy on the Completion Rate of the Perioperative Chemotherapy Regimen in Gastric Cancer: A Swedish Nationwide Study.

Tsekrekos A, Borg D, Johansson V, Nilsson M, Klevebro F, Lundell L Ann Surg Oncol. 2023; 30(12):7196-7205.

PMID: 37505355 PMC: 10562295. DOI: 10.1245/s10434-023-13967-6.

Surgical considerations and outcomes of minimally invasive approaches for gastric cancer resection.

Ong C, Schwarz J, Roggin K Cancer. 2022; 128(22):3910-3918.

PMID: 36191278 PMC: 9828344. DOI: 10.1002/cncr.34440.

Disparities in Utilization and Outcomes of Minimally Invasive Techniques for Gastric Cancer Surgery in the United States.

Park J, Verma A, Tran Z, Mederos M, Benharash P, Girgis M Ann Surg Oncol. 2022; 29(5):3136-3146.

PMID: 34994911 PMC: 8990946. DOI: 10.1245/s10434-021-11193-6.

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