Risk Factors for Death from Other Diseases After Curative Gastrectomy and Lymph Node Dissection for Gastric Cancer

Overview

Journal BMC Surg

Publisher Biomed Central

Specialty General Surgery

Date 2024 Jan 8

PMID 38191419

Authors

Takaaki Hanyu

Hiroshi Ichikawa

Yosuke Kano

Takashi Ishikawa

Yusuke Muneoka

Yuki Hirose

Kohei Miura

Yosuke Tajima

Yoshifumi Shimada

Jun Sakata

Toshifumi Wakai

Affiliations

Soon will be listed here.

Abstract

Background: Recent advances in treatment are expected to bring a cure to more patients with gastric cancer (GC). Focusing on the risk of death from other diseases (DOD) has become a crucial issue in patients cured of GC. The aim of this study was to elucidate the risk factors for DOD in patients who underwent curative gastrectomy with lymph node dissection for GC.

Methods: We enrolled 810 patients who underwent curative gastrectomy with lymph node dissection for GC from January 1990 to December 2014 and had no recurrence or death of GC until December 2019. We investigated the risk factors for DOD defined as death excluding death from a malignant neoplasm, accident, or suicide after gastrectomy, focusing on the perioperative characteristics at gastrectomy.

Results: Among 315 deaths from any cause, 210 died from diseases other than malignancy, accidents and suicide. The leading cause of DOD was pneumonia in 54 patients (25.7%). The actual survival period in 167 patients (79.5%) with DOD was shorter than their estimated life expectancy at gastrectomy. Multivariate analysis revealed that a high Charlson Comorbidity Index score (score 1-2: hazard ratio [HR] 2.192, 95% confidence interval [CI] 1.713-2.804, P < 0.001 and score ≥ 3: HR 4.813, 95% CI 3.022-7.668, P < 0.001), total gastrectomy (HR 1.620, 95% CI 1.195-2.197, P = 0.002) and the presence of postoperative complications (HR 1.402, 95% CI 1.024-1.919, P = 0.035) were significant independent risk factors for DOD after gastrectomy for GC, in addition to age of 70 years or higher, performance status of one or higher and body mass index less than 22.0 at gastrectomy.

Conclusions: Pneumonia is a leading cause of DOD after curative gastrectomy and lymph node dissection for GC. Paying attention to comorbidities, minimizing the choice of total gastrectomy and avoiding postoperative complications are essential to maintain the long-term prognosis after gastrectomy.

Citing Articles

Risk factors for serious postoperative complications following gastrectomy in super-elderly patients ≥85-years-old with gastric cancer: A National Clinical Database study in Japan.

Ueda Y, Nishimura S, Inomata M, Akagi T, Shiroshita H, Etoh T Ann Gastroenterol Surg. 2025; 9(1):79-88.

PMID: 39759983 PMC: 11693583. DOI: 10.1002/ags3.12843.

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