Surgical morbidity and mortality after neoadjuvant chemotherapy in the CRITICS gastric cancer trial
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| Title: | Surgical morbidity and mortality after neoadjuvant chemotherapy in the CRITICS gastric cancer trial |
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| Authors: | Y.H.M. Claassen, H.H. Hartgrink, J.L. Dikken, W.O. de Steur, J.W. van Sandick, N.C.T. van Grieken, A. Cats, A.K. Trip, E.P.M. Jansen, W.M. Meershoek-Klein Kranenbarg, J.P.B.M. Braak, H. Putter, M.I. van Berge Henegouwen, M. Verheij, C.J.H. van de Velde |
| Source: | Claassen, Y H M, Hartgrink, H H, Dikken, J L, de Steur, W O, van Sandick, J W, van Grieken, N C T, Cats, A, Trip, A K, Jansen, E P M, Meershoek-Klein Kranenbarg, W M, Braak, J P B M, Putter, H, van Berge Henegouwen, M I, Verheij, M & van de Velde, C J H 2018, 'Surgical morbidity and mortality after neoadjuvant chemotherapy in the CRITICS gastric cancer trial', European Journal of Surgical Oncology, vol. 44, no. 5, pp. 613-619. https://doi.org/10.1016/j.ejso.2018.02.004 European Journal of Surgical Oncology, 44, 5, pp. 613-619 |
| Publisher Information: | Elsevier BV, 2018. |
| Publication Year: | 2018 |
| Subject Terms: | Postoperative Complications/epidemiology, Adult, Male, Surgical morbidity, Epirubicin/administration & dosage, Anastomotic Leak, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, Gastrectomy, Antineoplastic Combined Chemotherapy Protocols, Gastric cancer surgery, Humans, Organoplatinum Compounds/administration & dosage, Mortality, Capecitabine, Randomized Controlled Trials as Topic, Aged, Epirubicin, Aged, 80 and over, Stomach Neoplasms/therapy, Radboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences, Induction Chemotherapy, Middle Aged, Surgical mortality, Neoadjuvant Therapy, 3. Good health, Oxaliplatin, Esophagectomy, Logistic Models, Capecitabine/administration & dosage, Anastomotic Leak/epidemiology, Radiation Oncology - Radboud University Medical Center, Multivariate Analysis, Splenectomy, Lymph Node Excision, Female, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Cisplatin, Cisplatin/administration & dosage |
| Description: | In order to determine the optimal combination of perioperative chemotherapy and chemoradiotherapy for Western patients with advanced resectable gastric cancer, the international multicentre CRITICS trial (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach) was initiated. In this trial, patients with resectable gastric cancer were randomised before start of treatment between adjuvant chemotherapy or adjuvant chemoradiotherapy following neoadjuvant chemotherapy plus gastric cancer resection. The purpose of this study was to report on surgical morbidity and mortality in this trial, and to identify factors associated with surgical morbidity.Patients who underwent a gastrectomy with curative intent were selected. Logistic regression analyses were used to assess risk factors for developing postoperative complications.Between 2007 and 2015, 788 patients were included in the CRITICS trial, of whom 636 patients were eligible for current analyses. Complications occurred in 296 patients (47%). Postoperative mortality was 2.2% (n = 14). Complications due to anastomotic leakage was cause of death in 5 patients. Failure to complete preoperative chemotherapy (OR = 2.09, P = 0.004), splenectomy (OR = 2.82, P = 0.012), and male sex (OR = 1.55, P = 0.020) were associated with a greater risk for postoperative complications. Total gastrectomy and oesophago-cardia resection were associated with greater risk for morbidity compared with subtotal gastrectomy (OR = 1.88, P = 0.001 and OR = 1.89, P = 0.038).Compared to other Western studies, surgical morbidity in the CRITICS trial was slightly higher whereas mortality was low. Complications following anastomotic leakage was the most important factor for postoperative mortality. Important proxies for developing postoperative complications were failure to complete preoperative chemotherapy, splenectomy, male sex, total gastrectomy, and oesophago-cardia resection. |
| Document Type: | Article |
| Language: | English |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2018.02.004 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/29503129 https://research.vumc.nl/en/publications/surgical-morbidity-and-mortality-after-neoadjuvant-chemotherapy-i https://pubmed.ncbi.nlm.nih.gov/29503129/ https://europepmc.org/article/MED/29503129 https://www.sciencedirect.com/science/article/abs/pii/S074879831830297X https://www.ncbi.nlm.nih.gov/pubmed/29503129 https://core.ac.uk/display/159753016 https://research.vumc.nl/en/publications/b1c5c7f6-78a4-4d68-873d-02b42737fe2c https://hdl.handle.net/1887/95505 https://pure.amsterdamumc.nl/en/publications/bde8ef49-de14-4d98-b8fc-9f8bca8e0f60 https://doi.org/10.1016/j.ejso.2018.02.004 https://hdl.handle.net/2066/193644 https://pure.au.dk/portal/en/publications/325d548a-81bc-4cd1-bcce-b31482dd0f26 https://doi.org/10.1016/j.ejso.2018.02.004 |
| Rights: | Elsevier TDM |
| Accession Number: | edsair.doi.dedup.....8d1da91713f4978827881dc294312a16 |
| Database: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | In order to determine the optimal combination of perioperative chemotherapy and chemoradiotherapy for Western patients with advanced resectable gastric cancer, the international multicentre CRITICS trial (ChemoRadiotherapy after Induction chemotherapy In Cancer of the Stomach) was initiated. In this trial, patients with resectable gastric cancer were randomised before start of treatment between adjuvant chemotherapy or adjuvant chemoradiotherapy following neoadjuvant chemotherapy plus gastric cancer resection. The purpose of this study was to report on surgical morbidity and mortality in this trial, and to identify factors associated with surgical morbidity.Patients who underwent a gastrectomy with curative intent were selected. Logistic regression analyses were used to assess risk factors for developing postoperative complications.Between 2007 and 2015, 788 patients were included in the CRITICS trial, of whom 636 patients were eligible for current analyses. Complications occurred in 296 patients (47%). Postoperative mortality was 2.2% (n = 14). Complications due to anastomotic leakage was cause of death in 5 patients. Failure to complete preoperative chemotherapy (OR = 2.09, P = 0.004), splenectomy (OR = 2.82, P = 0.012), and male sex (OR = 1.55, P = 0.020) were associated with a greater risk for postoperative complications. Total gastrectomy and oesophago-cardia resection were associated with greater risk for morbidity compared with subtotal gastrectomy (OR = 1.88, P = 0.001 and OR = 1.89, P = 0.038).Compared to other Western studies, surgical morbidity in the CRITICS trial was slightly higher whereas mortality was low. Complications following anastomotic leakage was the most important factor for postoperative mortality. Important proxies for developing postoperative complications were failure to complete preoperative chemotherapy, splenectomy, male sex, total gastrectomy, and oesophago-cardia resection. |
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| ISSN: | 07487983 |
| DOI: | 10.1016/j.ejso.2018.02.004 |