A1 Refereed original research article in a scientific journal

Postoperative Complications After Neoadjuvant Chemotherapy Versus Upfront Surgery in Gastric Adenocarcinoma : A Population-Based Nationwide Study in Finland




AuthorsPutila Emilia, Helminen Olli, Helmio Mika, Huhta Heikki, Jalkanen Aapo, Kallio Raija, Koivukangas Vesa, Kokkola Arto, Laine Simo, Lietzen Elina, Louhimo Johanna, Merilainen Sanna, Pohjanen Vesa-Matti, Rantanen Tuomo, Junttila Anna, Ristimäki Ari, Räsänen Jari V., Saarnio Juha, Sihvo Eero, Toikkanen Vesa, Tyrvainen Tuula, Valtola Antti, Kauppila Joonas H.; FINEGO Group

PublisherSpringer Nature

Publication year2023

JournalAnnals of Surgical Oncology

Journal name in sourceANNALS OF SURGICAL ONCOLOGY

Volume31

Issue4

First page 2689

Last page2698

ISSN1068-9265

eISSN1534-4681

DOIhttps://doi.org/10.1245/s10434-023-14813-5(external)

Web address https://link.springer.com/article/10.1245/s10434-023-14813-5(external)

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/381119136(external)


Abstract
Background

To date, no large population-based studies have compared complications and short-term outcomes between neoadjuvant chemotherapy and upfront surgery in gastric cancer. More nationwide studies with standardized reporting on complications are needed to enable international comparison between studies. This study aimed to compare postoperative complications between neoadjuvant therapy and upfront surgery after gastrectomy for gastric adenocarcinoma in a population-based setting.

Methods

This population-based study based on the Finnish National Esophago-Gastric Cancer Cohort included all patients 18 years of age or older undergoing gastrectomy for gastric adenocarcinoma in Finland during 2005–2016. Logistic regression provided odds ratios (ORs) with 95% confidence intervals (CIs), both crude and adjusted for key confounders. Different types of complications were graded based on the Esophagectomy Complications Consensus Group definitions, and major complications were assessed by the Clavien-Dindo scale.

Results

This study analyzed 769 patients. Neoadjuvant chemotherapy did not increase major postoperative complications after gastrectomy for gastric cancer compared with upfront surgery (OR, 1.12; 95% CI 0.81–1.56). Furthermore, it did not increase pneumonia, anastomotic complications, wound complications, or other complications.

Conclusions

Neoadjuvant therapy is not associated with increased postoperative complications, reoperations, or short-term mortality compared with upfront surgery in gastric adenocarcinoma.


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Funding information in the publication
This study was funded by the Finnish Medical Foundation (EP), Instrumentarium Science Foundation (OH), Finnish State Research Funding (O.H., J.H.K.), the Mary and Georg C. Ehrnrooth Foundation (O.H.), The Finnish Cancer Foundation (J.H.K.), the Paivikki and Sakari Sohlberg Foundation (J.H.K.), and the Sigrid Juselius Foundation (J.H.K.). The authors thank Minna Paaaho, the research nurse, and the administrative staff in the hospitals of Finland for aid in the data collection.


Last updated on 2024-28-11 at 12:19