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

FINEGO group

doi:10.1245/s10434-023-14813-5

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

FINEGO group

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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.

Original language	English
Journal	Annals of Surgical Oncology
DOIs	https://doi.org/10.1245/s10434-023-14813-5
Publication status	E-pub ahead of print - 28 Dec 2023
Publication type	A1 Journal article-refereed

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10.1245/s10434-023-14813-5Licence: CC BY

s10434-023-14813-5Final published version, 527 KBLicence: CC BY

https://urn.fi/URN:NBN:fi:tuni-202401221661Licence: CC BY

Cite this

@article{1e809b408d054753b4b176f3bccf464d,

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

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.",

author = "{FINEGO group} and Emilia Putila and Olli Helminen and Mika Helmi{\"o} and Heikki Huhta and Aapo Jalkanen and Raija Kallio and Vesa Koivukangas and Arto Kokkola and Simo Laine and Elina Lietzen and Johanna Louhimo and Sanna Meril{\"a}inen and Vesa-Matti Pohjanen and Tuomo Rantanen and Anna Junttila and Ari Ristim{\"a}ki and R{\"a}s{\"a}nen, {Jari V} and Juha Saarnio and Eero Sihvo and Vesa Toikkanen and Tuula Tyrv{\"a}inen and Antti Valtola and Kauppila, {Joonas H}",

note = "{\textcopyright} 2023. The Author(s).",

year = "2023",

month = dec,

day = "28",

doi = "10.1245/s10434-023-14813-5",

language = "English",

}

TY - JOUR

T1 - Postoperative Complications After Neoadjuvant Chemotherapy Versus Upfront Surgery in Gastric Adenocarcinoma

T2 - A Population-Based Nationwide Study in Finland

AU - FINEGO group

AU - Putila, Emilia

AU - Helminen, Olli

AU - Helmiö, Mika

AU - Huhta, Heikki

AU - Jalkanen, Aapo

AU - Kallio, Raija

AU - Koivukangas, Vesa

AU - Kokkola, Arto

AU - Laine, Simo

AU - Lietzen, Elina

AU - Louhimo, Johanna

AU - Meriläinen, Sanna

AU - Pohjanen, Vesa-Matti

AU - Rantanen, Tuomo

AU - Junttila, Anna

AU - Ristimäki, Ari

AU - Räsänen, Jari V

AU - Saarnio, Juha

AU - Sihvo, Eero

AU - Toikkanen, Vesa

AU - Tyrväinen, Tuula

AU - Valtola, Antti

AU - Kauppila, Joonas H

PY - 2023/12/28

Y1 - 2023/12/28

N2 - 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.

AB - 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.

U2 - 10.1245/s10434-023-14813-5

DO - 10.1245/s10434-023-14813-5

M3 - Article

C2 - 38153640

SN - 1068-9265

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

ER -

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

Abstract

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