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Impact of perioperative chemotherapy on postoperative morbidity after gastrectomy for gastric cancer

2021-08Journal article Restricted access
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dc.contributor.authorCabral, Francisco
dc.contributor.authorRamos, Paulo
dc.contributor.authorMonteiro, Cecília
dc.contributor.authorCasaca, Rui
dc.contributor.authorPinto, Iola
dc.contributor.authorAbecasis, Nuno
dc.date.accessioned2021-10-01T15:02:29Z
dc.date.available2021-10-01T15:02:29Z
dc.date.issued2021-08
dc.description.abstractIntroduction: The use of perioperative chemotherapy (CT) in patients with advanced gastric carcinoma increases their overall survival. This therapy may also increase the number of patients with R0 resection. Potential drawbacks of this therapy, besides its toxicity, include increased surgical morbidity. Methods: We retrospectively evaluated the records of patients undergoing gastrectomy with curative intent, for carcinoma, at our institution between January 2009 and August 2018. They were divided into two groups: direct surgery (SURG) and perioperative CT (CHEMO). Patients with other neoadjuvant therapies and cardia Siewert I and II carcinomas were excluded. The primary objective was to evaluate the impact of perioperative CT on surgical morbidity. As secondary objectives, resection radicality and total lymph node count were compared between the two groups. Results: A total of 307 patients (97 direct surgery and 210 perioperative CT) were evaluated. Median age was 67 years old. The overall major surgical morbidity (Clavien-Dindo 3-5) was 10.6% in the CHEMO group and 12.4 in the SURG group (p = 0.643). There was no statistically significant difference between the surgical radicality (R0 98% in the SURG group vs 97.5% CHEMO group (p = 0.865). There was an increase in the total number of lymph nodes retrieved in the specimen in the CHEMO group (25 vs 22, p = 0.001), a difference that was not maintained in the subgroup analysis as a function of the surgery performed. Conclusions: Perioperative CT in gastric carcinoma does not increase surgical morbidity, surgical radicality and total lymph node count. (C) 2020 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.pt_PT
dc.description.abstractIntroducción: El uso de quimioterapia perioperatoria (QT) en pacientes con carcinoma gástrico avanzado aumenta su supervivencia. Esta terapia también puede aumentar el número de pacientes con resección R0. Entre los posibles inconvenientes de esta terapia, además desu toxicidad, está una mayor morbilidad quirúrgica.El objetivo principal fue evaluar el impacto de la QT perioperatoria en la morbilidadquirúrgica. Como objetivos secundarios, la radicalidad de la resección y el recuento total deganglios linfáticos, que se compararon entre los dos grupos. Métodos: Evaluamos retrospectivamente los registros de pacientes sometidos a gastrectomía con intención curativa para carcinoma, en nuestra institución, entre enero de 2009 yagosto de 2018. Se dividieron en dos grupos: cirugía directa (SURG) y QT perioperatoria(CHEMO).Se evaluóun total de 307 pacientes (97 SURG y 210 CHEMO). La mediana de edad fue de67 anos.Resultados: La morbilidad quirúrgica mayor (Clavien-Dindo 3-5) fue de 10,6% en el grupoCHEMO y de 12,4 en el grupo SURG (p = 0,643).No hubo diferencias estadísticamente significativas entre el radical quirúrgico (R0 98% enel grupo de SURG vs. 97,5% del grupo CHEMO (p = 0,865). Hubo un aumento en el número totalde ganglios linfáticos recuperados en la muestra en el grupo CHEMO (25 vs. 22, p = 0,001), unadiferencia que no se mantuvo en el análisis de subgrupos en función de la cirugía realizada.Conclusiones: La QT perioperatoria en el carcinoma gástrico no aumenta la morbilidadquirúrgica, la radicalidad quirúrgica y el recuento total de ganglios linfáticos.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCABRAL, Francisco; [et al] – Impact of perioperative chemotherapy on postoperative morbidity after gastrectomy for gastric cancer. Cirugia Espanola. ISSN 0009-739X. Vol. 99, N.º 7 (2021), pp. 521-526pt_PT
dc.identifier.doi10.1016/j.ciresp.2020.09.006pt_PT
dc.identifier.eissn1578-147X
dc.identifier.issn0009-739X
dc.identifier.urihttp://hdl.handle.net/10400.21/13816
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Espanapt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S2173507721002039pt_PT
dc.subjectGastric cancerpt_PT
dc.subjectGastrectomypt_PT
dc.subjectPerioperative chemotherapypt_PT
dc.subjectSurgical morbiditypt_PT
dc.subjectCáncer gástricopt_PT
dc.subjectGastrectomíapt_PT
dc.subjectQuimioterapia perioperatoriapt_PT
dc.subjectMorbilidad quirúrgicapt_PT
dc.titleImpact of perioperative chemotherapy on postoperative morbidity after gastrectomy for gastric cancerpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage526pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage521pt_PT
oaire.citation.titleCirugia Espanolapt_PT
oaire.citation.volume99pt_PT
person.familyNameCabral
person.familyNamePinto
person.givenNameFrancisco
person.givenNameIola
person.identifierR-000-ME5
person.identifier.ciencia-id5715-2B2D-9ADC
person.identifier.orcid0000-0003-2992-7822
person.identifier.orcid0000-0002-2945-1441
person.identifier.scopus-author-id34969436900
rcaap.rightsclosedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication8e7bf490-0891-4c48-9678-c2cfb97b1ecc
relation.isAuthorOfPublication137d7dcc-401e-4d4a-862f-1d955c6f7257
relation.isAuthorOfPublication.latestForDiscovery8e7bf490-0891-4c48-9678-c2cfb97b1ecc

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