Morbidity and mortality rates following gastric cancer surgery and contiguous organ removal, a population based study.

S. Nanthakumaran, E. Fernandes, A. M. Thompson, T. Rapson, Fiona Jane Gilbert, K. G. Park

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Complete surgical. (R0) resection remains the only potentially curative intervention for patients with localised gastric cancer. To achieve a curative resection, patients may require complex operations with resection of contiguous organs. The aim of this study was to assess how the extent of surgical resection influenced morbidity, mortality and survival in an aged non-selected population with significant comorbid disease.

Patients and methods: Data were extracted from the Scottish Audit of Gastric and Oesophageal Cancer (SAGOC), a prospective population-based audit of all oesophageal and gastric cancers in Scotland between 1997 and 1999 with a minimum of 1-year follow-up.

Results: A total of 646 patients underwent surgical exploration for gastric cancer. A significantly higher incidence of chest infections (18.5 vs 11%, p<0.05) and anastomotic leaks (14.3 vs 2.2%, p<0.05) were associated with total gastrectomy (n = 168)when compared to distal gastrectomy (n=272) resections. A 9.2% mortality rate and a 60% 1-year survival were associated with gastric resection atone. Removal of the spleen (n = 131), pancreas (n = 30) or Liver resection (n = 5) was associated with a significantly higher mortality rates, 18.3, 23.3 and 40%, respectively (p <0.05), and significantly lower 1-year survival rates, 50.9, 39.1 and 20%, respectively (p < 0.05).

Conclusions: The risk of more extensive resection is not balanced by improved survival in this population based series. Extending gastric resection to involve contiguous organs should be confined to highly selected cases. (C) 2005 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)1141-1144
Number of pages3
JournalEuropean Journal of Surgical Oncology
Volume31
Issue number10
DOIs
Publication statusPublished - Dec 2005

Keywords

  • gastric cancer
  • morbidity
  • mortality
  • survival
  • surgical resection
  • LYMPH-NODE DISSECTION
  • PROGNOSTIC-FACTORS
  • LYMPHADENECTOMY
  • CARCINOMA
  • SURVIVAL
  • TRENDS
  • EUROPE
  • JAPAN

Cite this

Morbidity and mortality rates following gastric cancer surgery and contiguous organ removal, a population based study. / Nanthakumaran, S.; Fernandes, E.; Thompson, A. M.; Rapson, T.; Gilbert, Fiona Jane; Park, K. G.

In: European Journal of Surgical Oncology, Vol. 31, No. 10, 12.2005, p. 1141-1144.

Research output: Contribution to journalArticle

Nanthakumaran, S. ; Fernandes, E. ; Thompson, A. M. ; Rapson, T. ; Gilbert, Fiona Jane ; Park, K. G. / Morbidity and mortality rates following gastric cancer surgery and contiguous organ removal, a population based study. In: European Journal of Surgical Oncology. 2005 ; Vol. 31, No. 10. pp. 1141-1144.
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abstract = "Background: Complete surgical. (R0) resection remains the only potentially curative intervention for patients with localised gastric cancer. To achieve a curative resection, patients may require complex operations with resection of contiguous organs. The aim of this study was to assess how the extent of surgical resection influenced morbidity, mortality and survival in an aged non-selected population with significant comorbid disease.Patients and methods: Data were extracted from the Scottish Audit of Gastric and Oesophageal Cancer (SAGOC), a prospective population-based audit of all oesophageal and gastric cancers in Scotland between 1997 and 1999 with a minimum of 1-year follow-up.Results: A total of 646 patients underwent surgical exploration for gastric cancer. A significantly higher incidence of chest infections (18.5 vs 11{\%}, p<0.05) and anastomotic leaks (14.3 vs 2.2{\%}, p<0.05) were associated with total gastrectomy (n = 168)when compared to distal gastrectomy (n=272) resections. A 9.2{\%} mortality rate and a 60{\%} 1-year survival were associated with gastric resection atone. Removal of the spleen (n = 131), pancreas (n = 30) or Liver resection (n = 5) was associated with a significantly higher mortality rates, 18.3, 23.3 and 40{\%}, respectively (p <0.05), and significantly lower 1-year survival rates, 50.9, 39.1 and 20{\%}, respectively (p < 0.05).Conclusions: The risk of more extensive resection is not balanced by improved survival in this population based series. Extending gastric resection to involve contiguous organs should be confined to highly selected cases. (C) 2005 Elsevier Ltd. All rights reserved.",
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TY - JOUR

T1 - Morbidity and mortality rates following gastric cancer surgery and contiguous organ removal, a population based study.

AU - Nanthakumaran, S.

AU - Fernandes, E.

AU - Thompson, A. M.

AU - Rapson, T.

AU - Gilbert, Fiona Jane

AU - Park, K. G.

PY - 2005/12

Y1 - 2005/12

N2 - Background: Complete surgical. (R0) resection remains the only potentially curative intervention for patients with localised gastric cancer. To achieve a curative resection, patients may require complex operations with resection of contiguous organs. The aim of this study was to assess how the extent of surgical resection influenced morbidity, mortality and survival in an aged non-selected population with significant comorbid disease.Patients and methods: Data were extracted from the Scottish Audit of Gastric and Oesophageal Cancer (SAGOC), a prospective population-based audit of all oesophageal and gastric cancers in Scotland between 1997 and 1999 with a minimum of 1-year follow-up.Results: A total of 646 patients underwent surgical exploration for gastric cancer. A significantly higher incidence of chest infections (18.5 vs 11%, p<0.05) and anastomotic leaks (14.3 vs 2.2%, p<0.05) were associated with total gastrectomy (n = 168)when compared to distal gastrectomy (n=272) resections. A 9.2% mortality rate and a 60% 1-year survival were associated with gastric resection atone. Removal of the spleen (n = 131), pancreas (n = 30) or Liver resection (n = 5) was associated with a significantly higher mortality rates, 18.3, 23.3 and 40%, respectively (p <0.05), and significantly lower 1-year survival rates, 50.9, 39.1 and 20%, respectively (p < 0.05).Conclusions: The risk of more extensive resection is not balanced by improved survival in this population based series. Extending gastric resection to involve contiguous organs should be confined to highly selected cases. (C) 2005 Elsevier Ltd. All rights reserved.

AB - Background: Complete surgical. (R0) resection remains the only potentially curative intervention for patients with localised gastric cancer. To achieve a curative resection, patients may require complex operations with resection of contiguous organs. The aim of this study was to assess how the extent of surgical resection influenced morbidity, mortality and survival in an aged non-selected population with significant comorbid disease.Patients and methods: Data were extracted from the Scottish Audit of Gastric and Oesophageal Cancer (SAGOC), a prospective population-based audit of all oesophageal and gastric cancers in Scotland between 1997 and 1999 with a minimum of 1-year follow-up.Results: A total of 646 patients underwent surgical exploration for gastric cancer. A significantly higher incidence of chest infections (18.5 vs 11%, p<0.05) and anastomotic leaks (14.3 vs 2.2%, p<0.05) were associated with total gastrectomy (n = 168)when compared to distal gastrectomy (n=272) resections. A 9.2% mortality rate and a 60% 1-year survival were associated with gastric resection atone. Removal of the spleen (n = 131), pancreas (n = 30) or Liver resection (n = 5) was associated with a significantly higher mortality rates, 18.3, 23.3 and 40%, respectively (p <0.05), and significantly lower 1-year survival rates, 50.9, 39.1 and 20%, respectively (p < 0.05).Conclusions: The risk of more extensive resection is not balanced by improved survival in this population based series. Extending gastric resection to involve contiguous organs should be confined to highly selected cases. (C) 2005 Elsevier Ltd. All rights reserved.

KW - gastric cancer

KW - morbidity

KW - mortality

KW - survival

KW - surgical resection

KW - LYMPH-NODE DISSECTION

KW - PROGNOSTIC-FACTORS

KW - LYMPHADENECTOMY

KW - CARCINOMA

KW - SURVIVAL

KW - TRENDS

KW - EUROPE

KW - JAPAN

U2 - 10.1016/j.ejso.2005.03.013

DO - 10.1016/j.ejso.2005.03.013

M3 - Article

VL - 31

SP - 1141

EP - 1144

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 10

ER -