Low Creatinine Clearance is a Risk Factor for D2 Gastrectomy after Neoadjuvant Chemotherapy
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- 作者：Tsutomu Hayashi MD (1)
Toru Aoyama MD (1)
Kazuaki Tanabe MD (2)
Kazuhiro Nishikawa MD (3)
Yuichi Ito MD (4)
Takashi Ogata MD (1)
Haruhiko Cho MD (1)
Satoshi Morita PhD (5)
Yumi Miyashita (6)
Akira Tsuburaya MD (7)
Junichi Sakamoto MD (8)
Takaki Yoshikawa MD (1) - 刊名：Annals of Surgical Oncology
- 出版年：2014
- 出版时间：September 2014
- 年：2014
- 卷：21
- 期：9
- 页码：3015-3022
- 全文大小：192 KB
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Toru Aoyama MD (1)
Kazuaki Tanabe MD (2)
Kazuhiro Nishikawa MD (3)
Yuichi Ito MD (4)
Takashi Ogata MD (1)
Haruhiko Cho MD (1)
Satoshi Morita PhD (5)
Yumi Miyashita (6)
Akira Tsuburaya MD (7)
Junichi Sakamoto MD (8)
Takaki Yoshikawa MD (1)
1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan
2. Department of Gastrointestinal Surgery, Hiroshima University, Hiroshima, Japan
3. Department of Surgery, Osaka General Medical Center, Osaka, Japan
4. Department of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan
5. Department of Biostatistics and Epidemiology, Yokohama City University Medical Center, Yokohama, Japan
6. Data center, Nonprofit Organization ECRIN, Okazaki, Japan
7. Clinical Research Center, Shonan Kamakura General Hospital, Kamakura, Japan
8. Tokai Central Hospital, Kakamigahara, Japan - ISSN：1534-4681
文摘
Background The feasibility and safety of D2 surgery following neoadjuvant chemotherapy (NAC) has not been fully evaluated in patients with gastric cancer. Moreover, risk factor for surgical complications after D2 gastrectomy following NAC is also unknown. The purpose of the present study was to identify risk factors of postoperative complications after D2 surgery following NAC. Methods This study was conducted as an exploratory analysis of a prospective, randomized Phase II trial of NAC. The surgical complications were assessed and classified according to the Clavien–Dindo classification. A uni- and multivariate logistic regression analyses were performed to identify risk factors for morbidity. Results Among 83 patients who were registered to the Phase II trial, 69 patients received the NAC and D2 gastrectomy. Postoperative complications were identified in 18 patients and the overall morbidity rate was 26.1?%. The results of univariate and multivariate analyses of various factors for overall operative morbidity, creatinine clearance (CCr)?≤?0?ml/min (P?=?0.016) was identified as sole significant independent risk factor for overall morbidity. Occurrence of pancreatic fistula was significantly higher in the patients with a low CCr than in those with a high CCr. Conclusions Low CCr was a significant risk factor for surgical complications in D2 gastrectomy after NAC. Careful attention is required for these patients.