Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer
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 pati...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-024-02313-6 |
| _version_ | 1797355967372853248 |
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| author | Takaaki Hanyu Hiroshi Ichikawa Yosuke Kano Takashi Ishikawa Yusuke Muneoka Yuki Hirose Kohei Miura Yosuke Tajima Yoshifumi Shimada Jun Sakata Toshifumi Wakai |
| author_facet | Takaaki Hanyu Hiroshi Ichikawa Yosuke Kano Takashi Ishikawa Yusuke Muneoka Yuki Hirose Kohei Miura Yosuke Tajima Yoshifumi Shimada Jun Sakata Toshifumi Wakai |
| author_sort | Takaaki Hanyu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T14:19:51Z |
| format | Article |
| id | doaj.art-1cba975b2fdb42079cdf37cf9c3ded36 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-08T14:19:51Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-1cba975b2fdb42079cdf37cf9c3ded362024-01-14T12:07:15ZengBMCBMC Surgery1471-24822024-01-0124111110.1186/s12893-024-02313-6Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancerTakaaki Hanyu0Hiroshi Ichikawa1Yosuke Kano2Takashi Ishikawa3Yusuke Muneoka4Yuki Hirose5Kohei Miura6Yosuke Tajima7Yoshifumi Shimada8Jun Sakata9Toshifumi Wakai10Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesDivision of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental SciencesAbstract 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.https://doi.org/10.1186/s12893-024-02313-6Gastric cancerGastrectomyDeath from other diseasesRisk factorsComorbidityTotal gastrectomy |
| spellingShingle | Takaaki Hanyu Hiroshi Ichikawa Yosuke Kano Takashi Ishikawa Yusuke Muneoka Yuki Hirose Kohei Miura Yosuke Tajima Yoshifumi Shimada Jun Sakata Toshifumi Wakai Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer BMC Surgery Gastric cancer Gastrectomy Death from other diseases Risk factors Comorbidity Total gastrectomy |
| title | Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| title_full | Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| title_fullStr | Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| title_full_unstemmed | Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| title_short | Risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| title_sort | risk factors for death from other diseases after curative gastrectomy and lymph node dissection for gastric cancer |
| topic | Gastric cancer Gastrectomy Death from other diseases Risk factors Comorbidity Total gastrectomy |
| url | https://doi.org/10.1186/s12893-024-02313-6 |
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