In vivo (Athens, Greece) · 2026
The Clinical Impact of Postoperative Complications After Gastric Cancer Surgery for the Clinical Course of Adjuvant Treatment and Survival.
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Aoyama Toru, Cho Haruhiko, Hara Kentaro, Saito Aya
Аннотация
BACKGROUND/AIM: This study investigated whether postoperative complications (POCs) have a direct negative impact on survival or indirectly worsen survival outcomes by impairing the administration of adjuvant chemotherapy in patients with stage II/III gastric cancer (GC).
PATIENTS AND METHODS: Patients were retrospectively selected from the database of the Department of Gastric Surgery at the Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital (Tokyo, Japan). POCs were defined as postoperative complications of Clavien-Dindo grade II-V. Patients were categorized into two groups: those with POCs (C group) and those without POCs (NC group).
RESULTS: A total of 465 patients were included in this study, and POCs occurred in 134 patients (28.8%). The 3- and 5-year overall survival (OS) rates were 71.0% and 59.5% in the C group, and 77.7% and 71.2% in the NC group, respectively. The differences between the two groups were statistically significant (p=0.009). Multivariate analysis identified POCs as an independent prognostic factor for OS [hazard ratio (HR)=1.711; 95% confidence interval (CI)=1.182-2.476; p=0.004]. Regarding the postoperative course of adjuvant therapy, significant differences were observed between the C and NC groups in the rate of initiation of adjuvant chemotherapy (62.0% vs. 72.8%, p=0.021) and in the time to initiation after surgery (64 days vs. 48 days, p<0.001).
CONCLUSION: POCs were associated with poorer survival and adversely affected the administration of adjuvant chemotherapy after gastric cancer surgery. These findings suggest that POCs not only have a direct negative impact on survival but also indirectly worsen prognosis by compromising the delivery of postoperative adjuvant chemotherapy.
PATIENTS AND METHODS: Patients were retrospectively selected from the database of the Department of Gastric Surgery at the Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital (Tokyo, Japan). POCs were defined as postoperative complications of Clavien-Dindo grade II-V. Patients were categorized into two groups: those with POCs (C group) and those without POCs (NC group).
RESULTS: A total of 465 patients were included in this study, and POCs occurred in 134 patients (28.8%). The 3- and 5-year overall survival (OS) rates were 71.0% and 59.5% in the C group, and 77.7% and 71.2% in the NC group, respectively. The differences between the two groups were statistically significant (p=0.009). Multivariate analysis identified POCs as an independent prognostic factor for OS [hazard ratio (HR)=1.711; 95% confidence interval (CI)=1.182-2.476; p=0.004]. Regarding the postoperative course of adjuvant therapy, significant differences were observed between the C and NC groups in the rate of initiation of adjuvant chemotherapy (62.0% vs. 72.8%, p=0.021) and in the time to initiation after surgery (64 days vs. 48 days, p<0.001).
CONCLUSION: POCs were associated with poorer survival and adversely affected the administration of adjuvant chemotherapy after gastric cancer surgery. These findings suggest that POCs not only have a direct negative impact on survival but also indirectly worsen prognosis by compromising the delivery of postoperative adjuvant chemotherapy.