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Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis

BACKGROUND: Cohort studies have shown that neoadjuvant chemotherapy (NAC) is not associated with increased risk of postoperative complications and mortality as compared to upfront surgery (SURG). OBJECTIVE: The aim of this study was to compare postoperative morbidity and mortality after NAC with SUR...

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Autores principales: Wu, Liucheng, Ge, Lianying, Qin, Yuzhou, Huang, Mingwei, Chen, Jiansi, Yang, Yang, Zhong, Jianhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614824/
https://www.ncbi.nlm.nih.gov/pubmed/31308742
http://dx.doi.org/10.2147/CMAR.S203880
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author Wu, Liucheng
Ge, Lianying
Qin, Yuzhou
Huang, Mingwei
Chen, Jiansi
Yang, Yang
Zhong, Jianhong
author_facet Wu, Liucheng
Ge, Lianying
Qin, Yuzhou
Huang, Mingwei
Chen, Jiansi
Yang, Yang
Zhong, Jianhong
author_sort Wu, Liucheng
collection PubMed
description BACKGROUND: Cohort studies have shown that neoadjuvant chemotherapy (NAC) is not associated with increased risk of postoperative complications and mortality as compared to upfront surgery (SURG). OBJECTIVE: The aim of this study was to compare postoperative morbidity and mortality after NAC with SURG. PATIENTS AND METHODS: Patients who underwent gastrectomy with D2 lymphadenectomy for advanced gastric cancer (GC) between 2010 and 2017 were selected. The impact of neoadjuvant chemotherapy on surgical safety was investigated by using propensity score matching. RESULTS: Three hundred and seventy-seven patients were included. After propensity score matching, 86 patients in each group were matched. The percentage of patients with one or more complications was 10.5% in NAC group and 15.1% in SURG group (P=0.361), there was no mortality developed in either group. The total blood loss was significantly more in the NAC group than that in the SURG group (320.79 vs 243.37 ml, P<0.04). In univariate and multivariate of the matched cohort, sex, age (<70), BMI (<24), ASA grade, surgical procedure (open vs laparoscopy), gastrectomy extent, cTNM and Charlson index comorbidity were not associated with postoperative complications (all P>0.05). CONCLUSION: This study showed that postoperative morbidity and mortality were similar for NAC group and SURG group.
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spelling pubmed-66148242019-07-15 Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis Wu, Liucheng Ge, Lianying Qin, Yuzhou Huang, Mingwei Chen, Jiansi Yang, Yang Zhong, Jianhong Cancer Manag Res Original Research BACKGROUND: Cohort studies have shown that neoadjuvant chemotherapy (NAC) is not associated with increased risk of postoperative complications and mortality as compared to upfront surgery (SURG). OBJECTIVE: The aim of this study was to compare postoperative morbidity and mortality after NAC with SURG. PATIENTS AND METHODS: Patients who underwent gastrectomy with D2 lymphadenectomy for advanced gastric cancer (GC) between 2010 and 2017 were selected. The impact of neoadjuvant chemotherapy on surgical safety was investigated by using propensity score matching. RESULTS: Three hundred and seventy-seven patients were included. After propensity score matching, 86 patients in each group were matched. The percentage of patients with one or more complications was 10.5% in NAC group and 15.1% in SURG group (P=0.361), there was no mortality developed in either group. The total blood loss was significantly more in the NAC group than that in the SURG group (320.79 vs 243.37 ml, P<0.04). In univariate and multivariate of the matched cohort, sex, age (<70), BMI (<24), ASA grade, surgical procedure (open vs laparoscopy), gastrectomy extent, cTNM and Charlson index comorbidity were not associated with postoperative complications (all P>0.05). CONCLUSION: This study showed that postoperative morbidity and mortality were similar for NAC group and SURG group. Dove 2019-07-03 /pmc/articles/PMC6614824/ /pubmed/31308742 http://dx.doi.org/10.2147/CMAR.S203880 Text en © 2019 Wu et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Wu, Liucheng
Ge, Lianying
Qin, Yuzhou
Huang, Mingwei
Chen, Jiansi
Yang, Yang
Zhong, Jianhong
Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title_full Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title_fullStr Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title_full_unstemmed Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title_short Postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
title_sort postoperative morbidity and mortality after neoadjuvant chemotherapy versus upfront surgery for locally advanced gastric cancer: a propensity score matching analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614824/
https://www.ncbi.nlm.nih.gov/pubmed/31308742
http://dx.doi.org/10.2147/CMAR.S203880
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