Parameters for Predicting Surgical Outcomes for Gastric Cancer Patients: Simple Is Better Than Complex

Ali Guner, Sang Yong Kim, Jae Eun Yu, In Kyung Min, Yun Ho Roh, Chulkyu Roh, Won Jun Seo, Minah Cho, Seohee Choi, Yoon Young Choi, Taeil Son, Jae Ho Cheong, Woo Jin Hyung, Sung Hoon Noh, Hyoung Il Kim

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11 Citations (Scopus)

Abstract

Background: Various parameters are used to predict perioperative surgical outcomes. However, no comprehensive studies in gastrectomy have been conducted. This study aimed to compare the performance of each parameter in patients with gastric cancer. Methods: The medical records of 1032 gastric cancer patients who underwent curative gastrectomy between 2009 and 2015 were reviewed. Laboratory values and associated parameters (neutrophil count, lymphocyte count, platelet count, albumin level, Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and Systemic Immune-Inflammation Index) as well as body weight-related data and associated parameters [body mass index (BMI), percentage of weight loss, Nutritional Risk Screening 2002 assessment, the Malnutrition Universal Screening Tool, and the Nutritional Risk Index] were measured and calculated. The study end points were major complications, operative mortality, prolonged hospital stay, overall survival (OS), and recurrence-free survival (RFS). Results: Multivariable logistic regression analysis showed that male gender, total gastrectomy, advanced-stage gastric cancer, and low albumin level were risk factors for major complications. Old age, total gastrectomy, advanced-stage cancer, and high BMI were risk factors for operative mortality. Old age, open approach, and total gastrectomy were risk factors for prolonged hospital stay. Multivariable Cox proportional hazards models showed that old age, total gastrectomy, advanced-stage cancer, and high neutrophil count were unfavorable risk factors for OS. Old age, advanced-stage cancer, high neutrophil count, and high BMI were unfavorable risk factors for RFS. Conclusions: Albumin level, BMI, and neutrophil count are the most useful parameters for predicting short- and long-term surgical outcomes. Compared with complex parameters, simple-to-measure parameters are better for predicting surgical outcomes for gastric cancer patients.

Original languageEnglish
Pages (from-to)3239-3247
Number of pages9
JournalAnnals of surgical oncology
Volume25
Issue number11
DOIs
Publication statusPublished - 2018 Oct 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

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    Guner, A., Kim, S. Y., Yu, J. E., Min, I. K., Roh, Y. H., Roh, C., Seo, W. J., Cho, M., Choi, S., Choi, Y. Y., Son, T., Cheong, J. H., Hyung, W. J., Noh, S. H., & Kim, H. I. (2018). Parameters for Predicting Surgical Outcomes for Gastric Cancer Patients: Simple Is Better Than Complex. Annals of surgical oncology, 25(11), 3239-3247. https://doi.org/10.1245/s10434-018-6684-2