scholarly journals 1472P Association among blood transfusion, post-operative infectious complications, and cancer specific survival in patients with stage II/III gastric cancer after radical gastrectomy: Emphasizing benefit from chemotherapy

2020 ◽  
Vol 31 ◽  
pp. S919
Author(s):  
H. Xiao ◽  
F. Wu ◽  
J. Luo
Keyword(s):  
Gastric Cancer ◽  
Blood Transfusion ◽  
Infectious Complications ◽  
Stage Ii ◽  
Radical Gastrectomy ◽  
Cancer Specific Survival

scholarly journals Association Among Blood Transfusion, Postoperative Infectious Complications, and Cancer-Specific Survival in Patients with Stage II/III Gastric Cancer After Radical Gastrectomy: Emphasizing Benefit from Adjuvant Chemotherapy

2020 ◽  
Author(s):  
Hua Xiao ◽  
Yanping Xiao ◽  
Pan Chen ◽  
Hu Quan ◽  
Jia Luo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Blood Transfusion ◽  
Cox Regression ◽  
Infectious Complications ◽  
Additive Effect ◽  
Stage Ii ◽  
Radical Gastrectomy ◽  
Cancer Specific Survival ◽  
Cox Regression Analysis

Abstract Objectives This study was designed to investigate the potential additive influence of perioperative blood transfusion (BTF) and postoperative infections on cancer-specific survival (CSS) in patients with stage II/III gastric cancer (GC) after radical gastrectomy. Methods The medical records of 2114 consecutive stage II/III GC patients who underwent curative resection and planned to receive adjuvant chemotherapy (AC) were retrospectively reviewed. The independent predictive factors for infections were identified using univariate and multivariate analyses. Cox regression analysis was used to assess any associations between BTF, infection and CSS. Results A total of 507 (24.0%) received perioperative BTF and 148 (7.0%) developed infections with BTF being identified as an independent predictor for infections. Both BTF and infections independently predicted poor CSS (hazard ratio [HR]: 1.193, 95% confidence interval [CI] 1.007–1.414; HR 1.323, 95% CI 1.013–1.727) and an additive effect was confirmed as patients who had both BTF and infection had even worse CSS. Further stratified analyses showed that complete AC (≥ 6 cycles) could significantly improve CSS in patients who had BTF and/or infection, which was comparable to those without BTF and/or infection (P = 0.496). Conclusions Infection was the most common complication after gastrectomy and BTF was identified as an independent risk factor. BTF was associated with shorter CSS in stages II/III GC, independent of infections, and receiving BTF and developing infections had an additive effect that was associated with even worse CSS. However, complete AC could significantly improve CSS in these patients. Thus, strategies designed to ensure the completion of AC, such as neoadjuvant chemotherapy, should be further investigated.

scholarly journals Adjuvant chemotherapy is an additional option for locally advanced gastric cancer after radical gastrectomy with D2 lymphadenectomy: a retrospective control study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lei Chen ◽  
Chenghai Zhang ◽  
Zhendan Yao ◽  
Ming Cui ◽  
Jiadi Xing ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Locally Advanced ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Radical Gastrectomy ◽  
D2 Lymphadenectomy ◽  
D2 Gastrectomy ◽  
Group A ◽  
Group B

Abstract Background This study compared the long-term efficacy of different durations of adjuvant chemotherapy for patients with gastric cancer after radical gastrectomy with D2 lymphadenectomy. Methods We retrospectively identified 428 patients with stage II–III gastric cancer who underwent D2 gastrectomy between 2009 and 2016. Patients were divided into four groups according to the duration of adjuvant chemotherapy, including 0 week (no adjuvant, group A), 20 to 24 weeks (completed 7–8 cycles every 3 weeks or 10–12 cycles every 2 weeks, group B), and 12 to18 weeks (completed 4–6 cycles every 3 weeks or 6–9 cycles every 2 weeks, group C), and less than 12 weeks (received up to 3 cycles every 3 weeks or 5 cycles every 2 weeks, group D). The chemotherapy regimens included XELOX, SOX, and FOLFOX. 5-year overall survival (OS) and disease-free survival (DFS) were analyzed. Results The 5-year OS rates for groups A, B, C, and D were 52.3, 73.7, 72.0, and 53.3%, respectively, and the 5-year DFS rates were 50.0, 68.0, 65.4, and 50.0%, respectively. OS and DFS were higher in group B than in groups A and D. Similarly, patients in group C were more likely to have higher OS and DFS than those in groups A and D. Meanwhile, there were no significant differences in OS and DFS between groups B and C. The multivariate analysis confirmed with high statistical significance the efficacy of complete courses of adjuvant chemotherapy, and, among them, the similar impact of 4–6/6–9 and 7–8/10–12 cycles, resulting in similar HRs vs Group A (0.52 and 0.42, respectively). Conclusions To reduce toxicity and maintain efficacy, XELOX or SOX chemotherapy regimens administered for 4–6 cycles every 3 weeks or FOLFOX regimen for 6–9 cycles every 2 weeks might be a favorable option for patients with stage II–III gastric cancer after D2 gastrectomy. Prospective multicenter clinical trials with adequate sample sizes are necessary to verify these findings.

scholarly journals The effect of peroperative erythrocyte transfusion on infectious complications in patients with gastric cancer undergoing curative gastrectomy

2021 ◽  
Vol 8 (2) ◽  
pp. 503
Author(s):  
Ahmet Sencer Ergin ◽  
Ogün Erşen ◽  
Ümit Mercan ◽  
Cemil Yüksel ◽  
Salim Demirci
Keyword(s):  
Gastric Cancer ◽  
Blood Transfusion ◽  
Surgical Site Infection ◽  
Infectious Complications ◽  
Site Infection ◽  
Curative Surgery ◽  
Curative Gastrectomy ◽  
Infection Incidence ◽  
Surgical Site Infection Incidence ◽  
Anastomosis Leakage

Background: In this study, the effect of perioperative blood transfusion on infectious complications in patients undergoing curative surgery for gastric adenocarcinoma was investigated.Methods: The clinicopathological results of 312 patients who underwent curative gastrectomy were retrospectively analyzed. The effect of blood transfusion on the development of postoperative infectious complications were statistically analyzed.Results: In the subgroup of patients with intraoperative transfusion, surgical site infection incidence was found to be significantly higher in patient with 2U above ES transfusions. (p=0.014). In the subgroup of patients with postoperative transfusion, hospital stay (p<0.001), postoperative CRP values (p<0.001), surgical site infection incidence (p=0.049) and anastomosis leakage incidence (p<0.001) were found to be significantly higher in patient with 2U above ES transfusions. In the subgroup of patients with both intraoperative and postoperative transfusion, SSI, anastomotic leakage and any infective complication incidences were found to be significantly higher in patients with 2U and above transfusions. In multivariate analysis, age (p=0.015), BMI (p=0.011), intraoperative transfusion (p=0.011) and both intraoperative and postoperative transfusion (p=0.045) were found to be independent risk factors for infective complications.Conclusions: It was found that performing peroperative ES transfusion is associated with increased rates of infectious complications in patients undergoing curative gastrectomy for gastric cancer by causing immunomodulation.

scholarly journals Prognostic Impact of Postoperative Systemic Inflammatory Response in Patients with Stage II/III Gastric Cancer

2021 ◽  
Author(s):  
Kenji Kuroda ◽  
Takahiro Toyokawa ◽  
Yuichiro Miki ◽  
Mami Yoshii ◽  
Tatsuro Tamura ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Inflammatory Response ◽  
Systemic Inflammation ◽  
Early Phase ◽  
Prognostic Significance ◽  
Infectious Complications ◽  
Systemic Inflammatory Response ◽  
Stage Ii ◽  
Prognostic Impact ◽  
Maximum Serum

Abstract Background: Several studies have shown that postoperative infectious complications correlate with poor prognosis in various malignancies, but the prognostic significance of the postoperative inflammatory response in patients with gastric cancer remains unclear. This study examined whether the systemic inflammatory response present in the early phase of the postoperative state correlates with long-term outcomes and to identify markers in patients with stage II/III gastric cancer.Methods: This study retrospectively reviewed 444 consecutive patients who underwent radical gastrectomy for stage II/III gastric cancer. We evaluated maximum serum C-reactive protein (CRPmax) and white blood cell count (WBCmax), defined as the maximum serum CRP level and maximum WBC count during the interval from surgery until discharge, as systemic inflammation markers.Results: In univariate analyses, CRPmax, WBCmax and infectious complications were significantly associated with both overall survival (OS) (p<0.001, p<0.001 and p=0.011, respectively) and relapse-free survival (RFS) (p<0.001, p=0.001 and p<0.001, respectively). Multivariate analysis revealed that high-CRPmax (>9.2 mg/dL) was an independent prognostic factor for OS (hazard ratio (HR) 1.69, 95% confidence interval (CI) 1.18–2.42, p=0.004) and RFS (HR 1.42, 95%CI 1.02–1.98, p=0.038), while WBCmax and infectious complications were not. Conclusion: CRPmax, which reflects the magnitude of systemic inflammation induced by surgical stress and postoperative complications in the early phase after surgery, may be a promising prognostic indicator in patients with stage II/III gastric cancer who undergo curative resection.

scholarly journals Comprehensive Complication Index Predicts Cancer-Specific Survival of Patients with Postoperative Complications after Curative Resection of Gastric Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Ru-Hong Tu ◽  
Jian-Xian Lin ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
Jia-Bin Wang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Postoperative Complications ◽  
Prognostic Impact ◽  
Radical Gastrectomy ◽  
Comprehensive Complication Index ◽  
Cancer Specific Survival ◽  
Independent Risk Factors ◽  
The Difference ◽  
Gastric Cancer Patients

Objective. To investigate the prognostic impact of postoperative complications for patients with gastric cancer. Methods. Postoperative complications of patients undergoing radical gastrectomy for gastric cancer were reviewed. The severity of complications was graded by the CCI and C-D classification. Results. A total of 5327 patients were included in the study. Complications were observed in 767 patients. When the C-D classification system was applied, for patients with grade I–II complications, the length of stay (LOS) of those with high CCI (CCI ≥ 26.2) was significantly longer than that of patients with low CCI (CCI < 26.2) (p<0.001). The 5-year cancer-specific survival rate of patients with complications (52%) was lower than that of patients without complications (61%) (p<0.001). Analysis of the factors associated with prognosis in patients with gastric cancer revealed that complications were independent risk factors for specific survival. When CCI was used to classify complication severity, the 5-year cancer-specific survival rate of the high-CCI group was 46.3%, which was lower than that of the low-CCI group (54.9%, p=0.009). Conclusion. Complication after radical gastrectomy is an independent prognostic factor, and the complication severity as graded by CCI reflects the difference of cancer-specific survival in gastric cancer patients with postoperative complications.

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