Perioperative, short-, and long-term outcomes of gastric cancer surgery: Propensity score-matched analysis of patients with or without prior solid organ transplantation
- Authors
- Kim, Deok Gie; Seo, Won Jun; Cho, Minah; Kim, Yoo Min; Huh, Kyu Ha; Cheong, Jae Ho; Hyung, Woo Jin; Kim, Myung Soo; Kim, Hyoung Il
- Issue Date
- Dec-2021
- Publisher
- W.B. Saunders Ltd
- Keywords
- Gastric cancer; Organ transplantation; Transplant recipients
- Citation
- European Journal of Surgical Oncology, v.47, no.12, pp 3105 - 3112
- Pages
- 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- European Journal of Surgical Oncology
- Volume
- 47
- Number
- 12
- Start Page
- 3105
- End Page
- 3112
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53826
- DOI
- 10.1016/j.ejso.2021.04.017
- ISSN
- 0748-7983
1532-2157
- Abstract
- Background: Details of perioperative outcomes and survival after gastric cancer surgery in prior transplant recipients have received minimal research attention. Methods: We performed an observational cohort study using the database of 20,147 gastric cancer patients who underwent gastrectomy at a single gastric cancer center in Korea. Forty-one solid organ recipients [kidney (n = 35), liver (n = 5), or heart (n = 1)] were matched with 205 controls using propensity score matching. Results: Operation time, blood loss, and postoperative pain were similar between groups. Short-term complication rates were similar between transplantation and control groups (22.0% vs. 20.1%, P = 0.777). Transplantation group patients with stage 1 gastric cancer experienced no recurrence, while those with stage 2/3 cancer had significantly higher recurrence risk compared to the controls (P = 0.049). For patients with stage 1 cancer, the transplantation group had a significantly higher rate of non-gastric cancer-related deaths compared to the controls (19.2% vs. 1.4%, P = 0.001). For those with stage 2/3 cancer, significantly lower proportion of the transplantation group received adjuvant chemotherapy compared to the control group (26.7% vs. 80.3%, P < 0.001). The transplantation group had a higher (albeit not statistically significant) rate of gastric cancer-related deaths compared to the controls (40.0% vs. 18.0%, P = 0.087). Conclusion: Transplant recipients and non-transplant recipients exhibited similar perioperative and short-term outcomes after gastric cancer surgery. From long-term outcome analyses, we suggest active surveillance for non-gastric cancer-related deaths in patients with early gastric cancer, as well as strict oncologic care in patients with advanced cancer, as effective strategies for transplant recipients. © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
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Collections - 2. Clinical Science > Department of Foregut Surgery > 1. Journal Articles
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