Predictors of 1-year mortality after gastrectomy for gastric cancer.
World J Surg
; 48(1): 138-150, 2024 01.
Article
en En
| MEDLINE
| ID: mdl-38686784
ABSTRACT
PURPOSE:
One-year mortality is important for referrals to specialist palliative care or advance care planning (ACP). This helps optimize comfort for those who cannot be cured or have a lower life expectancy. Few studies have investigated the risk factors for 1-year mortality after gastrectomy for gastric cancer (GC).METHODS:
A total of 1415 patients with gastric cancer (stages I-IV) who underwent gastrectomy between 2005 and 2020 were included. The patients were randomly assigned to the investigation group (n = 850) and validation group (n = 565) in a 32 ratio. In the investigation group, significant independent prognostic factors for predicting 1-year survival were identified. A scoring system for predicting 1-year mortality was developed which was validated in the validation group.RESULTS:
Multivariate analysis revealed that the following seven variables were significant independent factors for 1-year survival age â§78, preoperative comorbidity, total gastrectomy, postoperative complication (Clavien-Dindo classification CD ⧠3a), stage III and IV, and R2 resection. While developing a 1-year mortality score (OMS), an age â§78 was scored 2, preoperative comorbidity, total gastrectomy, and postoperative complication (CD ⧠3a) were scored 1, and stage III, IV, and R2-resection were scored 2, 3, and 3, respectively. OMS 3 had a sensitivity of 91% and a specificity of 66% for predicting death within 1 year. In the validation group, OMS 5 had a sensitivity of 55% and a specificity of 93% for predicting death within 1 year.CONCLUSIONS:
OMS may provide important information and help surgeons select the timing of ACP in patients with GC.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias Gástricas
/
Gastrectomía
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
World J Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón