Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers
Abstract Background Quality standards in postoperative outcomes have not yet been defined for gastric cancer surgery. Also, the effect of centralization of gastric cancer surgery on the improvement of postoperative outcomes continues to be debated. Short-term postoperative outcomes in gastric carcin...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-022-02804-x |
| _version_ | 1811249901394198528 |
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| author | Francisco-Javier Lacueva Javier Escrig-Sos Roberto Marti-Obiol Carmen Zaragoza Fernando Mingol Miguel Oviedo Nuria Peris Joaquin Civera Amparo Roig on behalf of the RECEG-CV group |
| author_facet | Francisco-Javier Lacueva Javier Escrig-Sos Roberto Marti-Obiol Carmen Zaragoza Fernando Mingol Miguel Oviedo Nuria Peris Joaquin Civera Amparo Roig on behalf of the RECEG-CV group |
| author_sort | Francisco-Javier Lacueva |
| collection | DOAJ |
| description | Abstract Background Quality standards in postoperative outcomes have not yet been defined for gastric cancer surgery. Also, the effect of centralization of gastric cancer surgery on the improvement of postoperative outcomes continues to be debated. Short-term postoperative outcomes in gastric carcinoma patients in centers with low-volume of annual gastrectomies were assessed. The effect of age on major postoperative morbidity and mortality was also analyzed. Methods Patients with gastric or gastroesophageal junction Siewert III type carcinomas who underwent surgical treatment with curative intent between January 2013 and December 2016 were included. Data were obtained from the population-based surgical registry Esophagogastric Carcinoma Registry of the Comunitat Valenciana (RECEG-CV). The RECEG-CV gathers information on demographic characteristics and comorbidity, preoperative study and neoadjuvant treatment, surgical procedure, pathological study, postoperative outcomes, and follow-up. Seventeen hospitals belonging to the public network participated in this registry. Results Data from 591 patients were analyzed. Postoperative major morbidity occurred in 154 (26.1%) patients. Overall 30-day or in-hospital mortality, and 90-day postoperative mortality rates were 8.6% and 10.1% respectively. Failure-to-rescue was 39% and it was significantly higher in patients aged 75 years or older in comparison with younger patients (55.3% vs 23.1% p < 0.001). In the multivariable analysis, age ≥ 75 years (p = 0.029), laparoscopic approach (p = 0.005), and total gastrectomy (p = 0.005) were associated with major postoperative morbidity. Age ≥ 75 years (p = 0.027), pulmonary complications (p = 0.001), cardiac complications (p = 0.001), leakage (p = 0.003), and hemorrhage (p = 0.013) were associated with postoperative mortality. Conclusions Centralization of gastric adenocarcinoma treatment in centers with higher annual caseload should be considered to improve the short-term postoperative outcomes in low-volume centers. Patients aged 75 or older had a significantly increased risk of major postoperative morbidity and mortality, and higher failure-to-rescue. |
| first_indexed | 2024-04-12T15:55:39Z |
| format | Article |
| id | doaj.art-fc3872a19f854bee9a728dcb09bf51a0 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-12T15:55:39Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-fc3872a19f854bee9a728dcb09bf51a02022-12-22T03:26:24ZengBMCWorld Journal of Surgical Oncology1477-78192022-10-0120111110.1186/s12957-022-02804-xShort-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centersFrancisco-Javier Lacueva0Javier Escrig-Sos1Roberto Marti-Obiol2Carmen Zaragoza3Fernando Mingol4Miguel Oviedo5Nuria Peris6Joaquin Civera7Amparo Roig8on behalf of the RECEG-CV groupHospital General Universitario de ElcheHospital General Universitario de CastellónHospital Clínico Universitario de ValenciaHospital General Universitario de AlicanteHospital Universitario y Politécnico La Fe de ValenciaHospital General Universitario de ValenciaHospital Universitario Doctor Peset de ValenciaHospital Universitario Arnau de Vilanova de ValenciaHospital Lluis Alcanyis de XativaAbstract Background Quality standards in postoperative outcomes have not yet been defined for gastric cancer surgery. Also, the effect of centralization of gastric cancer surgery on the improvement of postoperative outcomes continues to be debated. Short-term postoperative outcomes in gastric carcinoma patients in centers with low-volume of annual gastrectomies were assessed. The effect of age on major postoperative morbidity and mortality was also analyzed. Methods Patients with gastric or gastroesophageal junction Siewert III type carcinomas who underwent surgical treatment with curative intent between January 2013 and December 2016 were included. Data were obtained from the population-based surgical registry Esophagogastric Carcinoma Registry of the Comunitat Valenciana (RECEG-CV). The RECEG-CV gathers information on demographic characteristics and comorbidity, preoperative study and neoadjuvant treatment, surgical procedure, pathological study, postoperative outcomes, and follow-up. Seventeen hospitals belonging to the public network participated in this registry. Results Data from 591 patients were analyzed. Postoperative major morbidity occurred in 154 (26.1%) patients. Overall 30-day or in-hospital mortality, and 90-day postoperative mortality rates were 8.6% and 10.1% respectively. Failure-to-rescue was 39% and it was significantly higher in patients aged 75 years or older in comparison with younger patients (55.3% vs 23.1% p < 0.001). In the multivariable analysis, age ≥ 75 years (p = 0.029), laparoscopic approach (p = 0.005), and total gastrectomy (p = 0.005) were associated with major postoperative morbidity. Age ≥ 75 years (p = 0.027), pulmonary complications (p = 0.001), cardiac complications (p = 0.001), leakage (p = 0.003), and hemorrhage (p = 0.013) were associated with postoperative mortality. Conclusions Centralization of gastric adenocarcinoma treatment in centers with higher annual caseload should be considered to improve the short-term postoperative outcomes in low-volume centers. Patients aged 75 or older had a significantly increased risk of major postoperative morbidity and mortality, and higher failure-to-rescue.https://doi.org/10.1186/s12957-022-02804-xGastric cancerGastrectomyPostoperative outcomesPostoperative mortalityFailure to rescueAge |
| spellingShingle | Francisco-Javier Lacueva Javier Escrig-Sos Roberto Marti-Obiol Carmen Zaragoza Fernando Mingol Miguel Oviedo Nuria Peris Joaquin Civera Amparo Roig on behalf of the RECEG-CV group Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers World Journal of Surgical Oncology Gastric cancer Gastrectomy Postoperative outcomes Postoperative mortality Failure to rescue Age |
| title | Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers |
| title_full | Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers |
| title_fullStr | Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers |
| title_full_unstemmed | Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers |
| title_short | Short-term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low-volume centers |
| title_sort | short term postoperative outcomes of gastric adenocarcinoma patients treated with curative intent in low volume centers |
| topic | Gastric cancer Gastrectomy Postoperative outcomes Postoperative mortality Failure to rescue Age |
| url | https://doi.org/10.1186/s12957-022-02804-x |
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