Fan-Feng Chen1, Fei-Yu Zhang1, Xuan-You Zhou2, Xian Shen3, Zhen Yu4, Cheng-Le Zhuang5,6. 1. Department of Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. 2. The First Clinical Medical Institute, Wenzhou Medical University, Wenzhou, China. 3. Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. 4. Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, 200072, China. yuzhen0577@gmail.com. 5. Department of Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China. zhuangchengle@126.com. 6. Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, 301 Yanchang Road, Shanghai, 200072, China. zhuangchengle@126.com.
Abstract
PURPOSE: This study was performed to determine the association of frailty and nutritional status with postoperative complications after total gastrectomy (TG) with D2 lymphadenectomy in patients with gastric cancer. METHODS: Patients undergoing TG with D2 lymphadenectomy for gastric cancer between August 2014 and February 2016 were enrolled. Frailty was evaluated by sarcopenia which was diagnosed by a combination of third lumbar vertebra muscle index (L3 MI), handgrip strength, and 6-m usual gait speed. Nutritional status was evaluated by the nutritional risk screening 2002 (NRS 2002) score. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. RESULTS: A total of 158 patients were analyzed, and 27.2 % developed complications within 30 days of surgery. One patient died within 30 days of the operation. In the univariate analyses, NRS 2002 score ≥3 (OR = 2.468, P = 0.012), sarcopenia (OR = 2.764, P = 0.008), and tumor located at the cardia (OR = 2.072, P = 0.046) were associated with the postoperative complications. Multivariable analysis revealed that sarcopenia (OR = 3.084, P = 0.005) and tumor located at the cardia (OR = 2.347, P = 0.026) were independent predictors of postoperative complications. CONCLUSIONS: This study showed a significant relationship between postoperative complications and geriatric frailty using sarcopenia in patients with gastric cancer after TG with D2 lymphadenectomy. Frailty should be integrated into preoperative risk assessment and may have implications in preoperative decisionmaking.
PURPOSE: This study was performed to determine the association of frailty and nutritional status with postoperative complications after total gastrectomy (TG) with D2 lymphadenectomy in patients with gastric cancer. METHODS:Patients undergoing TG with D2 lymphadenectomy for gastric cancer between August 2014 and February 2016 were enrolled. Frailty was evaluated by sarcopenia which was diagnosed by a combination of third lumbar vertebra muscle index (L3 MI), handgrip strength, and 6-m usual gait speed. Nutritional status was evaluated by the nutritional risk screening 2002 (NRS 2002) score. Univariate and multivariate analyses evaluating the risk factors for postoperative complications were performed. RESULTS: A total of 158 patients were analyzed, and 27.2 % developed complications within 30 days of surgery. One patient died within 30 days of the operation. In the univariate analyses, NRS 2002 score ≥3 (OR = 2.468, P = 0.012), sarcopenia (OR = 2.764, P = 0.008), and tumor located at the cardia (OR = 2.072, P = 0.046) were associated with the postoperative complications. Multivariable analysis revealed that sarcopenia (OR = 3.084, P = 0.005) and tumor located at the cardia (OR = 2.347, P = 0.026) were independent predictors of postoperative complications. CONCLUSIONS: This study showed a significant relationship between postoperative complications and geriatric frailty using sarcopenia in patients with gastric cancer after TG with D2 lymphadenectomy. Frailty should be integrated into preoperative risk assessment and may have implications in preoperative decisionmaking.
Entities:
Keywords:
D2 lymphadenectomy; Frailty; Morbidity; Nutritional status; Sarcopenia; Total gastrectomy
Authors: Jeroen L A van Vugt; Stef Levolger; Robert J S Coelen; Ron W F de Bruin; Jan N M IJzermans Journal: J Surg Oncol Date: 2015-10-21 Impact factor: 3.454
Authors: J J Bonenkamp; J Hermans; M Sasako; C J van de Velde; K Welvaart; I Songun; S Meyer; J T Plukker; P Van Elk; H Obertop; D J Gouma; J J van Lanschot; C W Taat; P W de Graaf; M F von Meyenfeldt; H Tilanus Journal: N Engl J Med Date: 1999-03-25 Impact factor: 91.245
Authors: Lisa Martin; Laura Birdsell; Neil Macdonald; Tony Reiman; M Thomas Clandinin; Linda J McCargar; Rachel Murphy; Sunita Ghosh; Michael B Sawyer; Vickie E Baracos Journal: J Clin Oncol Date: 2013-03-25 Impact factor: 44.544
Authors: Katelin A Mirkin; Franklyn E Luke; Alexandra Gangi; Jose M Pimiento; Daniel Jeong; Christopher S Hollenbeak; Joyce Wong Journal: J Gastrointest Oncol Date: 2017-06
Authors: Carolina Palmela; Sónia Velho; Lisa Agostinho; Francisco Branco; Marta Santos; Maria Pia Costa Santos; Maria Helena Oliveira; João Strecht; Rui Maio; Marília Cravo; Vickie E Baracos Journal: J Gastric Cancer Date: 2017-03-14 Impact factor: 3.720