Preoperative predictors of postoperative complications after gastrectomy for gastric cancer, a population-based study in Finland
Putila, Emilia; Helminen, Olli; Helmiö, Mika; Huhta, Heikki; Jalkanen, Aapo; Junttila, Anna; Kallio, Raija; Koivukangas, Vesa; Kokkola, Arto; Lietzen, Elina; Louhimo, Johanna; Meriläinen, Sanna; Pohjanen, Vesa-Matti; Rantanen, Tuomo; Ristimäki, Ari; Räsänen, Jari V.; Sihvo, Eero; Toikkanen, Vesa; Tyrväinen, Tuula; Valtola, Antti; Kauppila, Joonas H.; on behalf of the FINEGO group (2025-02-10)
Putila, Emilia
Helminen, Olli
Helmiö, Mika
Huhta, Heikki
Jalkanen, Aapo
Junttila, Anna
Kallio, Raija
Koivukangas, Vesa
Kokkola, Arto
Lietzen, Elina
Louhimo, Johanna
Meriläinen, Sanna
Pohjanen, Vesa-Matti
Rantanen, Tuomo
Ristimäki, Ari
Räsänen, Jari V.
Sihvo, Eero
Toikkanen, Vesa
Tyrväinen, Tuula
Valtola, Antti
Kauppila, Joonas H.
on behalf of the FINEGO group
Elsevier
10.02.2025
Putila, E., Helminen, O., Helmiö, M., Huhta, H., Jalkanen, A., Junttila, A., Kallio, R., Koivukangas, V., Kokkola, A., Lietzen, E., Louhimo, J., Meriläinen, S., Pohjanen, V.-M., Rantanen, T., Ristimäki, A., Räsänen, J. V., Sihvo, E., Toikkanen, V., Tyrväinen, T., … Kauppila, J. H. (2025). Preoperative predictors of postoperative complications after gastrectomy for gastric cancer, a population-based study in Finland. European Journal of Surgical Oncology, 51(6), 109682. https://doi.org/10.1016/j.ejso.2025.109682.
https://creativecommons.org/licenses/by/4.0/
© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
https://creativecommons.org/licenses/by/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202502281872
https://urn.fi/URN:NBN:fi:oulu-202502281872
Tiivistelmä
Structured abstract
Introduction
International studies on preoperative risk factors of postoperative complications after gastrectomy for gastric cancer are few, and studies done in a population-based setting or using standardized definitions are lacking. Gastrectomy for gastric cancer is characterized by high complication rates and mortality, and identifying the risk factors for postoperative complications and mortality enables to improve the postoperative outcomes.
Materials and methods
This nationwide population-based cohort study is based on the Finnish National Esophago-Gastric Cancer Cohort, and it included all patients undergoing gastric cancer surgery in Finland during 2005–2016 aged 18 years or older. The Esophagectomy Complications Consensus Group's (ECCG) standardized list of complications was used for describing different types of postoperative outcomes.
Results
This study analyzed a total of 1993 patients. The results suggested that of potential risk factors, higher ASA-class, and advanced tumor stage increased the risk of major postoperative complications after gastrectomy for gastric cancer, whereas age ≥70 years and distal tumor location may be protective factors. The results suggested that older age, higher ASA-class, comorbidity, and advanced tumor stage were risk factors for 90-day mortality. Older age seemed to be a risk factor for 90-day mortality, whereas it seemed to protect from major postoperative complications and 90-day reoperations.
Conclusions
Higher ASA-class, and advanced tumor stage were risk factors for major complications after gastrectomy for gastric cancer, while older age and distal tumor location seemed to be protective factors.
Introduction
International studies on preoperative risk factors of postoperative complications after gastrectomy for gastric cancer are few, and studies done in a population-based setting or using standardized definitions are lacking. Gastrectomy for gastric cancer is characterized by high complication rates and mortality, and identifying the risk factors for postoperative complications and mortality enables to improve the postoperative outcomes.
Materials and methods
This nationwide population-based cohort study is based on the Finnish National Esophago-Gastric Cancer Cohort, and it included all patients undergoing gastric cancer surgery in Finland during 2005–2016 aged 18 years or older. The Esophagectomy Complications Consensus Group's (ECCG) standardized list of complications was used for describing different types of postoperative outcomes.
Results
This study analyzed a total of 1993 patients. The results suggested that of potential risk factors, higher ASA-class, and advanced tumor stage increased the risk of major postoperative complications after gastrectomy for gastric cancer, whereas age ≥70 years and distal tumor location may be protective factors. The results suggested that older age, higher ASA-class, comorbidity, and advanced tumor stage were risk factors for 90-day mortality. Older age seemed to be a risk factor for 90-day mortality, whereas it seemed to protect from major postoperative complications and 90-day reoperations.
Conclusions
Higher ASA-class, and advanced tumor stage were risk factors for major complications after gastrectomy for gastric cancer, while older age and distal tumor location seemed to be protective factors.
Kokoelmat
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