Complication of Gastric Cancer Surgery: A Single Centre Experience

Overview

Journal In Vivo

Specialty Oncology

Date 2023 Aug 31

PMID 37652505

Authors

Marta Goglia

Sara Pepe

Marco Pace

Ludovica Fattori

Andrea Minervini

Diego Giulitti

Dario Sirimarco

Gaetano Gallo

Giuseppe Nigri

Giovanni Ramacciato

Paolo Aurello

Affiliations

Soon will be listed here.

Abstract

Background/aim: Gastric cancer surgery is still characterised by high morbidity and mortality. However, in 2018 an online platform, GASTRODATA has been proposed in Europe to standardize the recording of gastric surgery complications. The aim of the study was to present a single center experience regarding incidence and grading of acute postoperative complications in a population of patients treated surgically for gastric cancer on the basis of the gastrodata online platform.

Patients And Methods: The present study was a single center, observational, retrospective trial held in the General Surgery Unit of the Sant'Andrea Hospital of Rome. The study included 181 consecutive patients who underwent gastric surgical resection for cancer from May 2004 to December 2020 with curative R0 purpose.

Results: Thirty-three percent of patients reported at least one complication, while seventeen percent of the whole population reported a complication classified as at least grade 3 on the Clavien Dindo Classification. The most frequent complications were disorders of the respiratory system (13.3%), followed by bleeding (7.6%) and wound infections (6.2%). Deaths accounted for 3.7% of the population.

Conclusion: A list of defined complications of gastrectomy, if systematically adopted in the Literature, could lead to a reduction in the wide variation of proposals for treatment and assessment. Objectively evaluating the impact of complications on outcomes can lead to quality improvement project proposals.

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References

Baiocchi G, Giacopuzzi S, Marrelli D, Reim D, Piessen G, Da Costa P . International consensus on a complications list after gastrectomy for cancer. Gastric Cancer. 2018; 22(1):172-189. DOI: 10.1007/s10120-018-0839-5. View

Clavien P, Vetter D, Staiger R, Slankamenac K, Mehra T, Graf R . The Comprehensive Complication Index (CCI®): Added Value and Clinical Perspectives 3 Years "Down the Line". Ann Surg. 2017; 265(6):1045-1050. DOI: 10.1097/SLA.0000000000002132. View

Grasso M, Pacella G, Sangiuliano N, De Palma M, Puzziello A . Gastric cancer surgery: clinical outcomes and prognosis are influenced by perioperative blood transfusions. Updates Surg. 2019; 71(3):439-443. DOI: 10.1007/s13304-019-00622-7. View

Mortensen K, Nilsson M, Slim K, Schafer M, Mariette C, Braga M . Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Br J Surg. 2014; 101(10):1209-29. DOI: 10.1002/bjs.9582. View

Palmer P, Egger M, Philips P, McMasters K, Scoggins C, Martin R . Predictive preoperative and intraoperative factors of anastomotic leak in gastrectomy patients. Am J Surg. 2020; 220(2):376-380. DOI: 10.1016/j.amjsurg.2019.12.030. View

. Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). Gastric Cancer. 2022; 26(1):1-25. DOI: 10.1007/s10120-022-01331-8. View

LAUREN P . THE TWO HISTOLOGICAL MAIN TYPES OF GASTRIC CARCINOMA: DIFFUSE AND SO-CALLED INTESTINAL-TYPE CARCINOMA. AN ATTEMPT AT A HISTO-CLINICAL CLASSIFICATION. Acta Pathol Microbiol Scand. 1965; 64:31-49. DOI: 10.1111/apm.1965.64.1.31. View

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

Kocarnik J, Compton K, Dean F, Fu W, Gaw B, Harvey J . Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019. JAMA Oncol. 2021; 8(3):420-444. PMC: 8719276. DOI: 10.1001/jamaoncol.2021.6987. View

10.

Pedziwiatr M, Mavrikis J, Witowski J, Adamos A, Major P, Nowakowski M . Current status of enhanced recovery after surgery (ERAS) protocol in gastrointestinal surgery. Med Oncol. 2018; 35(6):95. PMC: 5943369. DOI: 10.1007/s12032-018-1153-0. View

11.

Nevo Y, Goldes Y, Barda L, Nadler R, Gutman M, Nevler A . Risk Factors for Complications of Total/Subtotal Gastrectomy for Gastric Cancer: Prospectively Collected, Based on the Clavien-Dindo Classification System. Isr Med Assoc J. 2018; 20(5):277-280. View

12.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008; 61(4):344-9. DOI: 10.1016/j.jclinepi.2007.11.008. View

13.

Gertsen E, Goense L, Brenkman H, van Hillegersberg R, Ruurda J . Identification of the clinically most relevant postoperative complications after gastrectomy: a population-based cohort study. Gastric Cancer. 2019; 23(2):339-348. PMC: 7031165. DOI: 10.1007/s10120-019-00997-x. View

14.

Marrelli D, Polom K, De Manzoni G, Morgagni P, Baiocchi G, Roviello F . Multimodal treatment of gastric cancer in the west: Where are we going?. World J Gastroenterol. 2015; 21(26):7954-69. PMC: 4499339. DOI: 10.3748/wjg.v21.i26.7954. View

15.

Baiocchi G, Giacopuzzi S, Vittimberga G, De Pascale S, Pastorelli E, Gelmini R . Clinical outcomes of patients with complicated post-operative course after gastrectomy for cancer: a GIRCG study using the GASTRODATA registry. Updates Surg. 2022; 75(2):419-427. PMC: 9852164. DOI: 10.1007/s13304-022-01318-1. View

16.

Joshi S, Badgwell B . Current treatment and recent progress in gastric cancer. CA Cancer J Clin. 2021; 71(3):264-279. PMC: 9927927. DOI: 10.3322/caac.21657. View

17.

Nakamura N, Kaida D, Tomita Y, Miyata T, Miyashita T, Fujita H . Risk Factors for Overall Complications and Remote Infection After Gastrectomy in Elderly Gastric Cancer Patients. In Vivo. 2021; 35(5):2917-2921. PMC: 8408687. DOI: 10.21873/invivo.12582. View

18.

Shannon A, Straker 3rd R, Fraker D, Roses R, Miura J, Karakousis G . Ninety-day mortality after total gastrectomy for gastric cancer. Surgery. 2021; 170(2):603-609. DOI: 10.1016/j.surg.2021.02.010. View

19.

Baiocchi G, Giacopuzzi S, Reim D, Piessen G, Da Costa P, Reynolds J . Incidence and Grading of Complications After Gastrectomy for Cancer Using the GASTRODATA Registry: A European Retrospective Observational Study. Ann Surg. 2020; 272(5):807-813. DOI: 10.1097/SLA.0000000000004341. View

20.

Ajani J, DAmico T, Bentrem D, Chao J, Cooke D, Corvera C . Gastric Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2022; 20(2):167-192. DOI: 10.6004/jnccn.2022.0008. View