Intraoperative Blood Loss is a Critical Risk Factor for Peritoneal Recurrence After Curative Resection of Advanced Gastric Cancer

Kamei, Takao; Kitayama, Joji; Yamashita, Hiroharu; Nagawa, Hirokazu

doi:10.1007/s00268-009-9979-4

Cited by 57 publications

(39 citation statements)

References 29 publications

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“…Though our study did analyze the correlation between prognosis and the amount of blood loss or operation time, these factors have been reported to be associated with postoperative complication and had an adverse impact on survival for GC in previous studies (21-24). …”

Section: Discussionmentioning

confidence: 94%

Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy

Zhang

Wang

et al. 2017

Chinese Journal of Cancer Research

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ObjectiveThough D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer (GC), the modified D2 (D1 + 7, 8a and 9) lymphadenectomy may be more suitable than D2 dissection for T2 stage GC. The purpose of this study is to elucidate whether the surgical outcome of modified D2 lymphadenectomy was comparable to that of standard D2 dissection in T2 stage GC patients.MethodsA retrospective cohort study with 77 cases and 77 controls matched for baseline characteristics was conducted. Patients were categorized into two groups according to the extent of lymphadenectomy: the modified D2 group (mD2) and the standard D2 group (D2). Surgical outcome and recurrence date were compared between the two groups.ResultsThe 5-year overall survival (OS) rate was 71.4% for patients accepted mD2 lymphadenectomy and 70.1% for those accepted standard D2, respectively, and the difference was not statistically significant. Multivariate survival analysis revealed that curability, tumor size, TNM stage and postoperative complications were independently prognostic factors for T2 stage GC patients. Patients in the mD2 group tended to have less intraoperative blood loss (P=0.001) and shorter operation time (P<0.001) than those in the D2 group. While there were no significant differences in recurrence rate and types, especially lymph node recurrence, between the two groups.ConclusionsThe surgical outcome of mD2 lymphadenectomy was equal to that of standard D2, and the use of mD2 instead of standard D2 can be a better option for T2 stage GC.

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Section: Discussionmentioning

confidence: 94%

Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy

Zhang

Wang

et al. 2017

Chinese Journal of Cancer Research

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“…A lower blood loss may reduce the chance of need blood transfusion. Previous study demonstrated that blood transfusion was associated with long-term survival in patients with resectable gastric cancer, and the relation was negatively impact (Kamei et al, 2009). And most studies demonstrated that perioperative blood transfusion increased cancer recurrence (Hyung et al, 2002;Linder et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of Outcomes Compared between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

Liao

Xie²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Another possible explanation is that EBL alters the recurrence patterns and leads to less favorable outcomes. Kamei et al [16] reported that excessive EBL is an independent risk factor for peritoneal recurrence after curative gastrectomy in GC. Viable cancer cells may actually be included in the blood that is lost into the peritoneal cavity during surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…The prognostic significance and optimal cutoff for predicting patients' outcomes as a function of EBL in GC remain controversial [15][16][17] . Inconsistency in the criteria for patient inclusion and analyses, combined with blood transfusion, are inextricably intertwined with EBL and are cited as a possible cause of the conflicting data.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer

et al. 2016

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Background/Aims: Gastrectomy with systemic lymphadenectomy sometimes causes excessive bleeding even by experienced surgeons. The aim of this study was to evaluate how intraoperative estimated blood loss (EBL) affected the long-term outcomes after curative surgery of patients with stage II/III gastric cancer (GC). Methods: This study included 203 patients with stage II/III GC who did not receive perioperative blood transfusion between 1999 and 2015. The optimal cutoff and the prognostic significance of EBL were determined retrospectively. Results: The median EBL was 285 ml. Receiver operating characteristic curve analysis identified 400 ml as an optimal cutoff. Patients with EBL ≥400 ml were more likely to have hepatic relapse and worse prognosis compared to those with EBL <400 ml. EBL ≥400 ml was identified as an independent prognostic factor for mortality by multivariable analysis. When patients were subdivided according to administration of adjuvant chemotherapy, there was a significant difference between the EBL ≥400 and <400 ml groups in patients who underwent surgery alone, whereas the prognosis was similar for patients of both groups who received adjuvant chemotherapy. Conclusion: EBL serves as a useful predictor for risk stratification after curative gastrectomy in patients with stage II/III GC.

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Intraoperative Blood Loss is a Critical Risk Factor for Peritoneal Recurrence After Curative Resection of Advanced Gastric Cancer

Cited by 57 publications

References 29 publications

Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy

Satisfactory surgical outcome of T2 gastric cancer after modified D2 lymphadenectomy

Meta-analysis of Outcomes Compared between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

Adverse Effects of Intraoperative Blood Loss on Long-Term Outcomes after Curative Gastrectomy of Patients with Stage II/III Gastric Cancer

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