Shinichi Umeda1, Mitsuro Kanda2, Koki Nakanishi1, Seiji Ito3, Yoshinari Mochizuki4, Hitoshi Teramoto5, Kiyoshi Ishigure6, Toshifumi Murai7, Takahiro Asada8, Akiharu Ishiyama9, Hidenobu Matsushita10, Dai Shimizu1, Daisuke Kobayashi4, Chie Tanaka1, Michitaka Fujiwara1, Kenta Murotani11, Yasuhiro Kodera1. 1. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65Tsurumai‑cho, Showa‑ku, Nagoya, Japan. 2. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, 65Tsurumai‑cho, Showa‑ku, Nagoya, Japan. m-kanda@med.nagoya-u.ac.jp. 3. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan. 4. Department of Surgery, Komaki City Hospital, Komaki, Japan. 5. Department of Surgery, Yokkaichi Municipal Hospital, Yokkaichi, Japan. 6. Department of Surgery, Konan Kosei Hospital, Konan, Japan. 7. Department of Surgery, Ichinomiya Municipal Hospital, Ichinomiya, Japan. 8. Department of Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Japan. 9. Department of Surgery, Okazaki City Hospital, Okazaki, Japan. 10. Department of Surgery, Tosei General Hospital, Seto, Japan. 11. Biostatistics Center, Graduate School of Medicine, Kurume University, Kurume, Japan.
Abstract
PURPOSE: Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy. METHODS: We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014. Patients with clinical stage-III gastric adenocarcinoma were divided into a neoadjuvant chemotherapy (NAC) group and a non-NAC group. We performed propensity-matched comparative analysis to stratify the groups according to age, sex, tumor region, tumor type, preoperative stage, procedure, lymph node dissection, and tumor differentiation. Preoperative blood data, surgical findings, and postoperative complications were analyzed. RESULTS: Analysis of the matched NAC (n = 64) and non-NAC (n = 128) groups revealed that the preoperative values of neutrophils, platelets, and Hb were significantly lower in the NAC group. Blood loss during surgery was significantly higher, surgical times were longer, and the rate of repeat surgery was significantly lower in the NAC group; however, the rates of rehospitalization did not differ between the groups and mortality was 0% in both groups. Postoperative complications were not significantly different between the groups. CONCLUSIONS: NAC did not increase the complication rate of gastrectomy for gastric cancer.
PURPOSE: Preoperative chemotherapy for gastric cancer may be effective from the standpoint of compliance, although there is insufficient evidence of its efficacy. We analyzed a multicenter database to clarify whether preoperative chemotherapy influenced the short-term outcomes of gastrectomy. METHODS: We analyzed, retrospectively, 3571 patients who underwent gastrectomy between January, 2010 and December, 2014. Patients with clinical stage-III gastric adenocarcinoma were divided into a neoadjuvant chemotherapy (NAC) group and a non-NAC group. We performed propensity-matched comparative analysis to stratify the groups according to age, sex, tumor region, tumor type, preoperative stage, procedure, lymph node dissection, and tumor differentiation. Preoperative blood data, surgical findings, and postoperative complications were analyzed. RESULTS: Analysis of the matched NAC (n = 64) and non-NAC (n = 128) groups revealed that the preoperative values of neutrophils, platelets, and Hb were significantly lower in the NAC group. Blood loss during surgery was significantly higher, surgical times were longer, and the rate of repeat surgery was significantly lower in the NAC group; however, the rates of rehospitalization did not differ between the groups and mortality was 0% in both groups. Postoperative complications were not significantly different between the groups. CONCLUSIONS:NAC did not increase the complication rate of gastrectomy for gastric cancer.