The Impact of Different Types of Complications on Long-Term Survival After Total Gastrectomy for Gastric Cancer.

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Mi Ran Jung, Sung Eun Kim, Oh Jeong
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Abstract

Purpose: This study aimed to investigate the impact of different types of complications on long-term survival following total gastrectomy for gastric cancer.

Materials and methods: A total of 926 patients who underwent total gastrectomy between 2008 and 2016 were included. Patients were divided into the morbidity and no-morbidity groups, and long-term survival was compared between the 2 groups. The prognostic impact of postoperative morbidity was assessed using a multivariate Cox proportional hazard model, which accounted for other prognostic factors. In the multivariate model, the effects of each complication on survival were analyzed.

Results: A total of 229 patients (24.7%) developed postoperative complications. Patients with postoperative morbidity showed significantly worse overall survival (OS) (5-year, 65.0% vs. 76.7%, P<0.001) and cancer-specific survival (CSS) (5-year, 74.2% vs. 83.1%, P=0.002) compared to those without morbidity. Multivariate analysis adjusting for other prognostic factors showed that postoperative morbidity remained an independent prognostic factor for OS (hazard ratio [HR], 1.442; 95% confidence interval [CI], 1.136-1.831) and CSS (HR, 1.463; 95% CI, 1.063-2.013). There was no significant difference in survival according to the severity of complications. The following complications showed a significant association with unfavorable long-term survival: ascites (HR, 1.868 for OS, HR, 2.052 for CSS), wound complications (HR, 2.653 for OS, HR, 2.847 for CSS), and pulmonary complications (HR, 2.031 for OS, HR, 1.915 for CSS).

Conclusions: Postoperative morbidity adversely impacted survival following total gastrectomy for gastric cancer. Among the different types of complications, ascites, wound complications, and pulmonary complications exhibited significant associations with long-term survival.

癌症全胃切除术后不同并发症类型对长期生存的影响。
目的:本研究旨在探讨癌症全胃切除术后不同类型并发症对长期生存的影响。材料和方法:纳入2008年至2016年间接受全胃切除术的926名患者。将患者分为发病组和无发病组,并比较两组患者的长期生存率。使用多变量Cox比例风险模型评估术后发病率对预后的影响,该模型考虑了其他预后因素。在多变量模型中,分析了每种并发症对生存率的影响。结果:共有229例(24.7%)患者出现术后并发症。术后发病率患者的总生存率(OS)显著降低(5年,65.0%对76.7%,P结论:癌症全胃切除术后,术后发病对生存率产生不利影响。在不同类型的并发症中,腹水、伤口并发症和肺部并发症与长期生存率显著相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.30%
发文量
567
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