Ninety-day mortality after total gastrectomy for gastric cancer

Ninety-day mortality after total gastrectomy for gastric cancer

Total gastrectomy for gastric cancer is associated with significant 30-day mortality, but this endpoint may underestimate the short-term mortality of the procedure. Retrospective analysis was performed using the National Cancer Database (2004−2015). Patients who underwent total gastrectomy for stage...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Surgery 2021-08, Vol.170 (2), p.603-609
Hauptverfasser: Shannon, Adrienne B., Straker, Richard J., Fraker, Douglas L., Roses, Robert E., Miura, John T., Karakousis, Giorgos C.
Format: Artikel
Sprache:eng
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 609
container_issue 2
container_start_page 603
container_title Surgery
container_volume 170
creator Shannon, Adrienne B.
Straker, Richard J.
Fraker, Douglas L.
Roses, Robert E.
Miura, John T.
Karakousis, Giorgos C.
description Total gastrectomy for gastric cancer is associated with significant 30-day mortality, but this endpoint may underestimate the short-term mortality of the procedure. Retrospective analysis was performed using the National Cancer Database (2004−2015). Patients who underwent total gastrectomy for stage I to III gastric adenocarcinoma were identified and divided into cohorts based on 90-day mortality. Predictors of mortality were analyzed using multivariable logistic regression, and annual trends in mortality rates were calculated by Joinpoint Regression. Of the 5,484 patients who underwent total gastrectomy, 90-day and 30-day mortality rates were 9.1% and 4.7%, respectively. Factors associated with 90-day mortality included increasing age (odds ratio 1.0, P < .001), income below the median (odds ratio 1.2, P = .039), Charlson-Deyo score ≥2 (odds ratio 1.4, P = .039), treatment at low-volume facilities (odds ratio 1.5, P < .001), N1 (odds ratio 2.0, P < .001), N2 (odds ratio 2.0, P < .001), or N3 (odds ratio 2.7, P < .001) stage disease, having
doi_str_mv 10.1016/j.surg.2021.02.010
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2507730990</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606021001033</els_id><sourcerecordid>2507730990</sourcerecordid><originalsourceid>FETCH-LOGICAL-c356t-4d79cab081f9a41407b7aad358a4325d873bef5ac9885990354152c6318c86353</originalsourceid><addsrcrecordid>eNp9kE1LxDAURYMozjj6B1xIl25aX5KmTUAQGfyCQTe6DmmaDhnayZikQv-9LVWXrh4X7rnwDkKXGDIMuLjZZaH324wAwRmQDDAcoSVmlKQlLfAxWgJQkRZQwAKdhbADAJFjfooWlJZccEyW6O7V7k0c0loNSed8VK2NQ6KaaHwS3RiTrQrRGx1dNySN83O2OtFqr40_RyeNaoO5-Lkr9PH48L5-TjdvTy_r-02qKStimtel0KoCjhuhcpxDWZVK1ZRxlVPCal7SyjRMacE5EwIoyzEjuqCYa15QRlfoet49ePfZmxBlZ4M2bav2xvVBEgZlSWFCV4jMVe1dCN408uBtp_wgMchJnNzJSZycxEkgchQ3Qlc_-33VmfoP-TU1Fm7nghm__LLGy6CtGRXUdrIja2f_2_8Gdcp-Gg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2507730990</pqid></control><display><type>article</type><title>Ninety-day mortality after total gastrectomy for gastric cancer</title><source>Access via ScienceDirect (Elsevier)</source><creator>Shannon, Adrienne B. ; Straker, Richard J. ; Fraker, Douglas L. ; Roses, Robert E. ; Miura, John T. ; Karakousis, Giorgos C.</creator><creatorcontrib>Shannon, Adrienne B. ; Straker, Richard J. ; Fraker, Douglas L. ; Roses, Robert E. ; Miura, John T. ; Karakousis, Giorgos C.</creatorcontrib><description><![CDATA[Total gastrectomy for gastric cancer is associated with significant 30-day mortality, but this endpoint may underestimate the short-term mortality of the procedure. Retrospective analysis was performed using the National Cancer Database (2004−2015). Patients who underwent total gastrectomy for stage I to III gastric adenocarcinoma were identified and divided into cohorts based on 90-day mortality. Predictors of mortality were analyzed using multivariable logistic regression, and annual trends in mortality rates were calculated by Joinpoint Regression. Of the 5,484 patients who underwent total gastrectomy, 90-day and 30-day mortality rates were 9.1% and 4.7%, respectively. Factors associated with 90-day mortality included increasing age (odds ratio 1.0, P < .001), income below the median (odds ratio 1.2, P = .039), Charlson-Deyo score ≥2 (odds ratio 1.4, P = .039), treatment at low-volume facilities (odds ratio 1.5, P < .001), N1 (odds ratio 2.0, P < .001), N2 (odds ratio 2.0, P < .001), or N3 (odds ratio 2.7, P < .001) stage disease, having <16 lymph nodes harvested (odds ratio 1.5, P < .001), and lack of treatment with chemotherapy (3.7, P < .001). Lack of health insurance (odds ratio 4.1, P = .080), and positive microscopic margins (odds ratio 1.3, P = .080) were correlated, but not significantly associated, with 90-day mortality. The 90-day mortality rate significantly declined from 14.3% in 2004 to 7.9% in 2015 (P = .006), and the 30-day mortality rate significantly declined from 7.7% in 2004 to 4.8% in 2015 (P = .009). Nearly half of the deaths within 90 days after total gastrectomy for cancer occur beyond 30 days postoperative. Ninety-day mortality has improved over time, but rates remain high, suggesting the need for improved out-of-hospital postoperative care beyond 30 days.]]></description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2021.02.010</identifier><identifier>PMID: 33789812</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><ispartof>Surgery, 2021-08, Vol.170 (2), p.603-609</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-4d79cab081f9a41407b7aad358a4325d873bef5ac9885990354152c6318c86353</citedby><cites>FETCH-LOGICAL-c356t-4d79cab081f9a41407b7aad358a4325d873bef5ac9885990354152c6318c86353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.surg.2021.02.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33789812$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shannon, Adrienne B.</creatorcontrib><creatorcontrib>Straker, Richard J.</creatorcontrib><creatorcontrib>Fraker, Douglas L.</creatorcontrib><creatorcontrib>Roses, Robert E.</creatorcontrib><creatorcontrib>Miura, John T.</creatorcontrib><creatorcontrib>Karakousis, Giorgos C.</creatorcontrib><title>Ninety-day mortality after total gastrectomy for gastric cancer</title><title>Surgery</title><addtitle>Surgery</addtitle><description><![CDATA[Total gastrectomy for gastric cancer is associated with significant 30-day mortality, but this endpoint may underestimate the short-term mortality of the procedure. Retrospective analysis was performed using the National Cancer Database (2004−2015). Patients who underwent total gastrectomy for stage I to III gastric adenocarcinoma were identified and divided into cohorts based on 90-day mortality. Predictors of mortality were analyzed using multivariable logistic regression, and annual trends in mortality rates were calculated by Joinpoint Regression. Of the 5,484 patients who underwent total gastrectomy, 90-day and 30-day mortality rates were 9.1% and 4.7%, respectively. Factors associated with 90-day mortality included increasing age (odds ratio 1.0, P < .001), income below the median (odds ratio 1.2, P = .039), Charlson-Deyo score ≥2 (odds ratio 1.4, P = .039), treatment at low-volume facilities (odds ratio 1.5, P < .001), N1 (odds ratio 2.0, P < .001), N2 (odds ratio 2.0, P < .001), or N3 (odds ratio 2.7, P < .001) stage disease, having <16 lymph nodes harvested (odds ratio 1.5, P < .001), and lack of treatment with chemotherapy (3.7, P < .001). Lack of health insurance (odds ratio 4.1, P = .080), and positive microscopic margins (odds ratio 1.3, P = .080) were correlated, but not significantly associated, with 90-day mortality. The 90-day mortality rate significantly declined from 14.3% in 2004 to 7.9% in 2015 (P = .006), and the 30-day mortality rate significantly declined from 7.7% in 2004 to 4.8% in 2015 (P = .009). Nearly half of the deaths within 90 days after total gastrectomy for cancer occur beyond 30 days postoperative. Ninety-day mortality has improved over time, but rates remain high, suggesting the need for improved out-of-hospital postoperative care beyond 30 days.]]></description><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAURYMozjj6B1xIl25aX5KmTUAQGfyCQTe6DmmaDhnayZikQv-9LVWXrh4X7rnwDkKXGDIMuLjZZaH324wAwRmQDDAcoSVmlKQlLfAxWgJQkRZQwAKdhbADAJFjfooWlJZccEyW6O7V7k0c0loNSed8VK2NQ6KaaHwS3RiTrQrRGx1dNySN83O2OtFqr40_RyeNaoO5-Lkr9PH48L5-TjdvTy_r-02qKStimtel0KoCjhuhcpxDWZVK1ZRxlVPCal7SyjRMacE5EwIoyzEjuqCYa15QRlfoet49ePfZmxBlZ4M2bav2xvVBEgZlSWFCV4jMVe1dCN408uBtp_wgMchJnNzJSZycxEkgchQ3Qlc_-33VmfoP-TU1Fm7nghm__LLGy6CtGRXUdrIja2f_2_8Gdcp-Gg</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>Shannon, Adrienne B.</creator><creator>Straker, Richard J.</creator><creator>Fraker, Douglas L.</creator><creator>Roses, Robert E.</creator><creator>Miura, John T.</creator><creator>Karakousis, Giorgos C.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20210801</creationdate><title>Ninety-day mortality after total gastrectomy for gastric cancer</title><author>Shannon, Adrienne B. ; Straker, Richard J. ; Fraker, Douglas L. ; Roses, Robert E. ; Miura, John T. ; Karakousis, Giorgos C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-4d79cab081f9a41407b7aad358a4325d873bef5ac9885990354152c6318c86353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shannon, Adrienne B.</creatorcontrib><creatorcontrib>Straker, Richard J.</creatorcontrib><creatorcontrib>Fraker, Douglas L.</creatorcontrib><creatorcontrib>Roses, Robert E.</creatorcontrib><creatorcontrib>Miura, John T.</creatorcontrib><creatorcontrib>Karakousis, Giorgos C.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shannon, Adrienne B.</au><au>Straker, Richard J.</au><au>Fraker, Douglas L.</au><au>Roses, Robert E.</au><au>Miura, John T.</au><au>Karakousis, Giorgos C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ninety-day mortality after total gastrectomy for gastric cancer</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>170</volume><issue>2</issue><spage>603</spage><epage>609</epage><pages>603-609</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract><![CDATA[Total gastrectomy for gastric cancer is associated with significant 30-day mortality, but this endpoint may underestimate the short-term mortality of the procedure. Retrospective analysis was performed using the National Cancer Database (2004−2015). Patients who underwent total gastrectomy for stage I to III gastric adenocarcinoma were identified and divided into cohorts based on 90-day mortality. Predictors of mortality were analyzed using multivariable logistic regression, and annual trends in mortality rates were calculated by Joinpoint Regression. Of the 5,484 patients who underwent total gastrectomy, 90-day and 30-day mortality rates were 9.1% and 4.7%, respectively. Factors associated with 90-day mortality included increasing age (odds ratio 1.0, P < .001), income below the median (odds ratio 1.2, P = .039), Charlson-Deyo score ≥2 (odds ratio 1.4, P = .039), treatment at low-volume facilities (odds ratio 1.5, P < .001), N1 (odds ratio 2.0, P < .001), N2 (odds ratio 2.0, P < .001), or N3 (odds ratio 2.7, P < .001) stage disease, having <16 lymph nodes harvested (odds ratio 1.5, P < .001), and lack of treatment with chemotherapy (3.7, P < .001). Lack of health insurance (odds ratio 4.1, P = .080), and positive microscopic margins (odds ratio 1.3, P = .080) were correlated, but not significantly associated, with 90-day mortality. The 90-day mortality rate significantly declined from 14.3% in 2004 to 7.9% in 2015 (P = .006), and the 30-day mortality rate significantly declined from 7.7% in 2004 to 4.8% in 2015 (P = .009). Nearly half of the deaths within 90 days after total gastrectomy for cancer occur beyond 30 days postoperative. Ninety-day mortality has improved over time, but rates remain high, suggesting the need for improved out-of-hospital postoperative care beyond 30 days.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>33789812</pmid><doi>10.1016/j.surg.2021.02.010</doi><tpages>7</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0039-6060
ispartof Surgery, 2021-08, Vol.170 (2), p.603-609
issn 0039-6060
1532-7361
language eng
recordid cdi_proquest_miscellaneous_2507730990
source Access via ScienceDirect (Elsevier)
title Ninety-day mortality after total gastrectomy for gastric cancer
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T22%3A48%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Ninety-day%20mortality%20after%20total%20gastrectomy%20for%20gastric%20cancer&rft.jtitle=Surgery&rft.au=Shannon,%20Adrienne%20B.&rft.date=2021-08-01&rft.volume=170&rft.issue=2&rft.spage=603&rft.epage=609&rft.pages=603-609&rft.issn=0039-6060&rft.eissn=1532-7361&rft_id=info:doi/10.1016/j.surg.2021.02.010&rft_dat=%3Cproquest_cross%3E2507730990%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2507730990&rft_id=info:pmid/33789812&rft_els_id=S0039606021001033&rfr_iscdi=true