Neoadjuvant radiation therapy does not increase perioperative morbidity among patients undergoing gastrectomy for gastric cancer

Zhifei Sun, Daniel P. Nussbaum, Paul J. Speicher, Brian G. Czito, Douglas Tyler, Dan G. Blazer

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Neoadjuvant radiation therapy (RT) as a component of the multimodality treatment of gastric cancer has demonstrated promising results. Data regarding its effect on perioperative safety are limited. Methods Adults undergoing gastrectomy for gastric cancer in the 2005-2011 National Surgical Quality Improvement Program were included. Groups were defined by neoadjuvant RT use, and then propensity-matched based on preoperative variables. Multivariable logistic regression was performed to assess neoadjuvant RT as an independent predictor of outcomes. Results Among 2,764 patients identified, 55 (2.0%) were treated with neoadjuvant RT. Patients who received neoadjuvant RT were more likely to have received preoperative chemotherapy and steroids, and experienced weight loss (all P < 0.01). After matching, however, there were no preoperative differences. At time of surgery, total (vs. partial) gastrectomy was more common among patients who underwent neoadjuvant RT (70.9 vs. 46.7%, P < 0.01), and operative time was longer (290 vs. 236 min, P < 0.01). There were no differences in overall complications (23.6 vs. 29.7%, P = 0.49) or 30-day mortality (3.6 vs. 3.6%, P = 0.99). Conclusions Neoadjuvant RT was not associated with increased morbidity or mortality following resection for gastric cancer. These findings support the ongoing investigation of neoadjuvant RT as part of the multidisciplinary management of resectable gastric cancer. J. Surg. Oncol. 2015 111:46-50.

Original languageEnglish (US)
Pages (from-to)46-50
Number of pages5
JournalJournal of Surgical Oncology
Volume112
Issue number1
DOIs
StatePublished - Jul 1 2015

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Neoadjuvant Therapy
Gastrectomy
Stomach Neoplasms
Radiotherapy
Morbidity
Background Radiation
Mortality
Operative Time
Quality Improvement
Weight Loss
Logistic Models
Steroids
Safety
Drug Therapy

Keywords

  • gastrectomy
  • gastric cancer
  • neoadjuvant radiation therapy
  • outcomes

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Neoadjuvant radiation therapy does not increase perioperative morbidity among patients undergoing gastrectomy for gastric cancer. / Sun, Zhifei; Nussbaum, Daniel P.; Speicher, Paul J.; Czito, Brian G.; Tyler, Douglas; Blazer, Dan G.

In: Journal of Surgical Oncology, Vol. 112, No. 1, 01.07.2015, p. 46-50.

Research output: Contribution to journalArticle

Sun, Zhifei ; Nussbaum, Daniel P. ; Speicher, Paul J. ; Czito, Brian G. ; Tyler, Douglas ; Blazer, Dan G. / Neoadjuvant radiation therapy does not increase perioperative morbidity among patients undergoing gastrectomy for gastric cancer. In: Journal of Surgical Oncology. 2015 ; Vol. 112, No. 1. pp. 46-50.
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abstract = "Background Neoadjuvant radiation therapy (RT) as a component of the multimodality treatment of gastric cancer has demonstrated promising results. Data regarding its effect on perioperative safety are limited. Methods Adults undergoing gastrectomy for gastric cancer in the 2005-2011 National Surgical Quality Improvement Program were included. Groups were defined by neoadjuvant RT use, and then propensity-matched based on preoperative variables. Multivariable logistic regression was performed to assess neoadjuvant RT as an independent predictor of outcomes. Results Among 2,764 patients identified, 55 (2.0{\%}) were treated with neoadjuvant RT. Patients who received neoadjuvant RT were more likely to have received preoperative chemotherapy and steroids, and experienced weight loss (all P < 0.01). After matching, however, there were no preoperative differences. At time of surgery, total (vs. partial) gastrectomy was more common among patients who underwent neoadjuvant RT (70.9 vs. 46.7{\%}, P < 0.01), and operative time was longer (290 vs. 236 min, P < 0.01). There were no differences in overall complications (23.6 vs. 29.7{\%}, P = 0.49) or 30-day mortality (3.6 vs. 3.6{\%}, P = 0.99). Conclusions Neoadjuvant RT was not associated with increased morbidity or mortality following resection for gastric cancer. These findings support the ongoing investigation of neoadjuvant RT as part of the multidisciplinary management of resectable gastric cancer. J. Surg. Oncol. 2015 111:46-50.",
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