Association of Antibiotic Used During Surgery With the Outcome in Stage I-III Gastric Cancer.

Abstract

Introduction: The use of antibiotic (Abx) is common in gastric cancer (GC) patients undergoing radical resection; however, the prognostic value of the use of these agents in stage I-III patients remains largely unknown.Methods: Data concerning the use of Abx in GC patients during surgery including the cumulative defined daily dose (cDDD) and types of Abx, were collected retrospectively. Differences in clinical features between cDDD subgroups and type subgroups were compared. Overall survival (OS) differences were tested via the Kaplan-Meier method, and risk factors for survival were validated by a Cox proportional hazards model.Results: Of 162 patients enrolled, 81 were assigned to the low-cDDD and 81 to the high-cDDD group. Among them, 19 patients were assigned to ≤2 types and 143 to ≥3 types. The low- and high-cDDD subgroups of patients presented no significant difference in OS (log rank = 2.21, P = 0.137). Patients receiving ≥3 types presented significantly better OS (log rank = 4.58, P = 0.032) than those receiving ≤2 types. The low- and high-cDDD subgroups (log rank = 3.83, P = 0.050), but not the ≤2 and ≥3 type subgroups (log rank<0.01, P = 0.982), presented a significant difference in OS in patients undergoing total gastrectomy. These differences were maintained in patients without total gastrectomy (cDDD: log rank = 7.92, P = 0.005; types: log rank = 6.52, P = 0.011). The use of multiple Abx types was validated as an independent factor for OS (HR = 0.46, 95% CI: 0.24-0.90; P = 0.024).Conclusions: Abx use during surgery in patients with stage I-III GC may potentially correlate with the prognosis. Patients with ≥3 types of Abx were more likely to have good outcomes, particularly in those without total gastrectomy.