Ali Guner1,2, Sang Yong Kim3, Jae Eun Yu3, In Kyung Min4, Yun Ho Roh4, Chulkyu Roh1, Won Jun Seo1, Minah Cho1, Seohee Choi1, Yoon Young Choi1, Taeil Son1, Jae-Ho Cheong1,5, Woo Jin Hyung1,5,6, Sung Hoon Noh1,5, Hyoung-Il Kim7,8,9,10. 1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. 2. Department of General Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. 3. Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei University Health System, Seoul, Korea. 4. Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea. 5. Gastric Cancer Center, Yonsei Cancer Hospital, Seoul, Korea. 6. Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Korea. 7. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. cairus@yuhs.ac. 8. Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei University Health System, Seoul, Korea. cairus@yuhs.ac. 9. Gastric Cancer Center, Yonsei Cancer Hospital, Seoul, Korea. cairus@yuhs.ac. 10. Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, Korea. cairus@yuhs.ac.
Abstract
BACKGROUND: Various parameters are used to predict perioperative surgical outcomes. However, no comprehensive studies in gastrectomy have been conducted. This study aimed to compare the performance of each parameter in patients with gastric cancer. METHODS: The medical records of 1032 gastric cancer patients who underwent curative gastrectomy between 2009 and 2015 were reviewed. Laboratory values and associated parameters (neutrophil count, lymphocyte count, platelet count, albumin level, Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and Systemic Immune-Inflammation Index) as well as body weight-related data and associated parameters [body mass index (BMI), percentage of weight loss, Nutritional Risk Screening 2002 assessment, the Malnutrition Universal Screening Tool, and the Nutritional Risk Index] were measured and calculated. The study end points were major complications, operative mortality, prolonged hospital stay, overall survival (OS), and recurrence-free survival (RFS). RESULTS: Multivariable logistic regression analysis showed that male gender, total gastrectomy, advanced-stage gastric cancer, and low albumin level were risk factors for major complications. Old age, total gastrectomy, advanced-stage cancer, and high BMI were risk factors for operative mortality. Old age, open approach, and total gastrectomy were risk factors for prolonged hospital stay. Multivariable Cox proportional hazards models showed that old age, total gastrectomy, advanced-stage cancer, and high neutrophil count were unfavorable risk factors for OS. Old age, advanced-stage cancer, high neutrophil count, and high BMI were unfavorable risk factors for RFS. CONCLUSIONS: Albumin level, BMI, and neutrophil count are the most useful parameters for predicting short- and long-term surgical outcomes. Compared with complex parameters, simple-to-measure parameters are better for predicting surgical outcomes for gastric cancer patients.
BACKGROUND: Various parameters are used to predict perioperative surgical outcomes. However, no comprehensive studies in gastrectomy have been conducted. This study aimed to compare the performance of each parameter in patients with gastric cancer. METHODS: The medical records of 1032 gastric cancerpatients who underwent curative gastrectomy between 2009 and 2015 were reviewed. Laboratory values and associated parameters (neutrophil count, lymphocyte count, platelet count, albumin level, Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and Systemic Immune-Inflammation Index) as well as body weight-related data and associated parameters [body mass index (BMI), percentage of weight loss, Nutritional Risk Screening 2002 assessment, the Malnutrition Universal Screening Tool, and the Nutritional Risk Index] were measured and calculated. The study end points were major complications, operative mortality, prolonged hospital stay, overall survival (OS), and recurrence-free survival (RFS). RESULTS: Multivariable logistic regression analysis showed that male gender, total gastrectomy, advanced-stage gastric cancer, and low albumin level were risk factors for major complications. Old age, total gastrectomy, advanced-stage cancer, and high BMI were risk factors for operative mortality. Old age, open approach, and total gastrectomy were risk factors for prolonged hospital stay. Multivariable Cox proportional hazards models showed that old age, total gastrectomy, advanced-stage cancer, and high neutrophil count were unfavorable risk factors for OS. Old age, advanced-stage cancer, high neutrophil count, and high BMI were unfavorable risk factors for RFS. CONCLUSIONS: Albumin level, BMI, and neutrophil count are the most useful parameters for predicting short- and long-term surgical outcomes. Compared with complex parameters, simple-to-measure parameters are better for predicting surgical outcomes for gastric cancerpatients.
Authors: Sung Hoon Kim; Bong Il Song; Hae Won Kim; Kyoung Sook Won; Young Gil Son; Seung Wan Ryu Journal: Korean J Radiol Date: 2020-07 Impact factor: 3.500