logistic Regression Analysis of Influencing Factors on Postoperative Complications and Mortality of Gastric Cancer after Total Gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FAN Tao , SONG Yingjie , DAI Dongqiu , XU Huimian , DENG Peng.

Department of Surgical Oncology, The First Affiliated Hospital, China Medical University, Shenyang 110001, China;

Corresponding author：

Keywords：

Gastric cancer; Postoperative complications; Mortality; logistic regression analysis

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the influencing factors on postoperative complications and mortality of gastric cancer after total gastrectomy.
Methods The clinical data of 622 patients with gastric cancer received total gastrectomy were collected. According to the extent of lymph node dissection, the patients were divided into 2 groups: D0/D1 group (n=35) and D2/D3 group (n=587). The risk factors influencing postoperative morbidity and mortality were determined by logistic multiple regression analysis.
Results The total postoperative complication morbidity and mortality for all patients were 9.81% (61/622) and 2.89% (18/622), respectively. The postoperative complication morbidity was 8.57% (3/35) and 9.88% (58/587) in the two groups, the postoperative mortality was 2.86% (1/35) and 2.90% (17/587) in the two groups, there were no significant differences between the two groups (P gt;0.05). The most common postoperative complication was intestinal obstruction (18.03%, 11/61). Multivariate analysis revealed that risk factors on the postoperative complications and mortality were age ≥ 70 years, TNM stage Ⅳ, preoperative complication, palliative excision, merely manual or mechanical anastomosis, and multivisceral resection (P lt;0.05), however, the extent of lymph node was not influencing factor (P gt;0.05).
Conclusions Patients with advanced gastric cancer have a high risk of postoperative complications and mortality. Multiple organ resection should be avoided for patients with gastric cancer of TNM stage Ⅳ.

Citation： FAN Tao,SONG Yingjie,DAI Dongqiu,XU Huimian,DENG Peng.. logistic Regression Analysis of Influencing Factors on Postoperative Complications and Mortality of Gastric Cancer after Total Gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(5): 482-485. doi: Copy

1.	Hansson LE, Ekstrom AM, Bergstrom R, et al. Surgery for stomach cancer in a defined Swedish population: current practices and operative results. Swedish Gastric Cancer Study Group [J]. Eur J Surg, 2000; 166(10): 787-795.
2.	Ikeguchi M, Oka S, Gomyo Y, et al. Postoperative morbidity and mortality after gastrectomy for gastric carcinoma [J]. Hepatogastroenterology, 2001; 48(41): 1517-1520.
3.	Pacelli F, Papa V, Rosa F, et al. Four hundred consecutive total gastrectomies for gastric cancer: a single-institution experience [J]. Arch Surg, 2008; 143(8): 769-775.
4.	Badruddoja M. Total gastrectomy [J]. Arch Surg, 2009; 144(3): 289-290.
5.	Ruiz E, Sanchez J, Celis J, et al. Surgical outcome of 801 patients with localized gastric cancer treated with d2 lymphadenectomy [J]. Rev Gastroenterol Peru, 2009; 29(2): 124-131.
6.	Gunther K, Horbach T, Merkel S, et al. D3 lymph node dissection in gastric cancer: evaluation of postoperative mortality and complications [J]. Surg Today， 2000; 30(8): 700-705.
7.	Edwards P, Blackshaw GR, Lewis WG, et al. Prospective comparison of D1 vs. modified D2 gastrectomy for carcinoma [J]. Br J Cancer, 2004; 90(10): 1888-1892.
8.	Oh SJ, Hyung WJ, Li C, et al. The effect of spleen-preserving lymphadenectomy on surgical outcomes of locally advanced proximal gastric cancer [J]. J Surg Oncol, 2009; 99(5): 275-280.
9.	Otsuji E, Kuriu Y, Ichikawa D, et al. Efficacy of prophylactic extended lymphadenectomy with gastrectomy for patients with node-negative advanced gastric carcinoma [J]. Hepatogastroenterology, 2008; 55(82-83): 755-759.
10.	Díaz de Liao A, Yárnoz C, Aguilar R, et al. Morbidity and mortality in gastrectomy with D2 lymphadenectomy in a specialised unit [J]. Cir Esp, 2008; 83(1):18-23.
11.	Degiuli M, Sasako M, Calgaro M, et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial [J]. Eur J Surg Oncol, 2004; 30(3): 303-308.
12.	张建中, 卢辉山, 黄昌明, 等. 615例胃癌行全胃切除术的远期疗效 [J]. 中华胃肠外科杂志, 2002; 5(1): 13-16.
13.	詹友庆, 李威, 孙晓卫, 等. 胃癌的外科治疗 [J]. 中华胃肠外科杂志, 2002; 5(1): 28-31.
14.	阚永丰, 郑毅, 李世拥, 等. 1 142例胃癌切除术围手术期死亡因素分析 [J]. 中华胃肠外科杂志, 2005; 8(5): 422-424.
15.	卢春茂, 汪振耿. 胃癌全胃切除术后两种消化道重建术式的比较 [J]. 中国普外基础与临床杂志, 2008; 15(8): 611-612.
16.	朱正纲. 全胃切除与消化道重建术在胃癌治疗中的临床意义 [J]. 中国普外基础与临床杂志, 2006; 13(1):15-16.
17.	曾玉剑, 程中, 周总光. 全胃切除术后消化道重建的现状 [J]. 中国普外基础与临床杂志, 2008; 15(5): 383-384.
18.	孙立波, 李永超, 冯野, 等. 全胃切除术后改良Orr式Roux-en-Y食管空肠吻合术的临床研究 [J]. 中国普外基础与临床杂志, 2008; 15(12): 917-919.
19.	肖仕明, 姜淮芜, 陈进, 等. 全胃切除调节型双通道间置空肠消化道重建 [J]. 中国普外基础与临床杂志, 2008; 15(1): 23-26.
20.	何运胜, 姜淮芜. 进展期胃癌多模式治疗的研究进展 [J]. 中国普外基础与临床杂志， 2008; 15(1): 31-35.　.
21.	Korenaga D, Yasuda M, Takesue F, et al. Factors influencing the development of small intestinal obstruction following total gastrectomy for gastric cancer: the impact of reconstructive route in the Roux-en-Y procedure [J]. Hepatogastroenterology, 2001; 48(41): 1389-1392.
22.	Ichikawa D, Kurioka H, Yamaguchi T, et al. Postoperative complications following gastrectomy for gastric cancer during the last decade [J]. Hepatogastroenterology, 2004; 51(56): 613-617.
23.	Oh SJ, Choi WB, Song J, et al. Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute [J]. J Gastrointest Surg, 2009; 13(2): 239-245.

1. Hansson LE, Ekstrom AM, Bergstrom R, et al. Surgery for stomach cancer in a defined Swedish population: current practices and operative results. Swedish Gastric Cancer Study Group [J]. Eur J Surg, 2000; 166(10): 787-795.
2. Ikeguchi M, Oka S, Gomyo Y, et al. Postoperative morbidity and mortality after gastrectomy for gastric carcinoma [J]. Hepatogastroenterology, 2001; 48(41): 1517-1520.
3. Pacelli F, Papa V, Rosa F, et al. Four hundred consecutive total gastrectomies for gastric cancer: a single-institution experience [J]. Arch Surg, 2008; 143(8): 769-775.
4. Badruddoja M. Total gastrectomy [J]. Arch Surg, 2009; 144(3): 289-290.
5. Ruiz E, Sanchez J, Celis J, et al. Surgical outcome of 801 patients with localized gastric cancer treated with d2 lymphadenectomy [J]. Rev Gastroenterol Peru, 2009; 29(2): 124-131.
6. Gunther K, Horbach T, Merkel S, et al. D3 lymph node dissection in gastric cancer: evaluation of postoperative mortality and complications [J]. Surg Today， 2000; 30(8): 700-705.
7. Edwards P, Blackshaw GR, Lewis WG, et al. Prospective comparison of D1 vs. modified D2 gastrectomy for carcinoma [J]. Br J Cancer, 2004; 90(10): 1888-1892.
8. Oh SJ, Hyung WJ, Li C, et al. The effect of spleen-preserving lymphadenectomy on surgical outcomes of locally advanced proximal gastric cancer [J]. J Surg Oncol, 2009; 99(5): 275-280.
9. Otsuji E, Kuriu Y, Ichikawa D, et al. Efficacy of prophylactic extended lymphadenectomy with gastrectomy for patients with node-negative advanced gastric carcinoma [J]. Hepatogastroenterology, 2008; 55(82-83): 755-759.
10. Díaz de Liao A, Yárnoz C, Aguilar R, et al. Morbidity and mortality in gastrectomy with D2 lymphadenectomy in a specialised unit [J]. Cir Esp, 2008; 83(1):18-23.
11. Degiuli M, Sasako M, Calgaro M, et al. Morbidity and mortality after D1 and D2 gastrectomy for cancer: interim analysis of the Italian Gastric Cancer Study Group (IGCSG) randomised surgical trial [J]. Eur J Surg Oncol, 2004; 30(3): 303-308.
12. 张建中, 卢辉山, 黄昌明, 等. 615例胃癌行全胃切除术的远期疗效 [J]. 中华胃肠外科杂志, 2002; 5(1): 13-16.
13. 詹友庆, 李威, 孙晓卫, 等. 胃癌的外科治疗 [J]. 中华胃肠外科杂志, 2002; 5(1): 28-31.
14. 阚永丰, 郑毅, 李世拥, 等. 1 142例胃癌切除术围手术期死亡因素分析 [J]. 中华胃肠外科杂志, 2005; 8(5): 422-424.
15. 卢春茂, 汪振耿. 胃癌全胃切除术后两种消化道重建术式的比较 [J]. 中国普外基础与临床杂志, 2008; 15(8): 611-612.
16. 朱正纲. 全胃切除与消化道重建术在胃癌治疗中的临床意义 [J]. 中国普外基础与临床杂志, 2006; 13(1):15-16.
17. 曾玉剑, 程中, 周总光. 全胃切除术后消化道重建的现状 [J]. 中国普外基础与临床杂志, 2008; 15(5): 383-384.
18. 孙立波, 李永超, 冯野, 等. 全胃切除术后改良Orr式Roux-en-Y食管空肠吻合术的临床研究 [J]. 中国普外基础与临床杂志, 2008; 15(12): 917-919.
19. 肖仕明, 姜淮芜, 陈进, 等. 全胃切除调节型双通道间置空肠消化道重建 [J]. 中国普外基础与临床杂志, 2008; 15(1): 23-26.
20. 何运胜, 姜淮芜. 进展期胃癌多模式治疗的研究进展 [J]. 中国普外基础与临床杂志， 2008; 15(1): 31-35.　.
21. Korenaga D, Yasuda M, Takesue F, et al. Factors influencing the development of small intestinal obstruction following total gastrectomy for gastric cancer: the impact of reconstructive route in the Roux-en-Y procedure [J]. Hepatogastroenterology, 2001; 48(41): 1389-1392.
22. Ichikawa D, Kurioka H, Yamaguchi T, et al. Postoperative complications following gastrectomy for gastric cancer during the last decade [J]. Hepatogastroenterology, 2004; 51(56): 613-617.
23. Oh SJ, Choi WB, Song J, et al. Complications requiring reoperation after gastrectomy for gastric cancer: 17 years experience in a single institute [J]. J Gastrointest Surg, 2009; 13(2): 239-245.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

logistic Regression Analysis of Influencing Factors on Postoperative Complications and Mortality of Gastric Cancer after Total Gastrectomy

Abstract Full text Figures/Tables Video References Cited by

Format

Content