Severe Complications After Gastrectomy for Esophagogastric Junction and Gastric Cancer

Gastric Cancer Clinical Trial

Official title:

Severe Complications After Gastrectomy for Esophagogastric Junction and Gastric Cancer: Perioperative Results and Long Term Survival

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03909997
• Other study ID #: 1
• Status: Recruiting
• Start date: April 5, 2019
• Est. completion date: April 5, 2022

Study information

• Verified date: April 2019
• Source: Hospital Dr Sotero del Rio
• Contact: Enrique M Norero, MD
• Phone: 56-2-3536601
• Email: enorero[@]yahoo.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. The aim of the present study is to identify the predictors of postoperative morbidity and to evaluate long term survival according to complications. This is a retrospective cohort study.

Description:

Gastrectomy is the main treatment for gastric and Siewert type II-III esophagogastric junction (EGJ) cancer. This surgery is associated with significant morbidity. The aim of the present study is to identify the predictors of postoperative morbidity and to evaluate long term survival according to complications.

This was a retrospective cohort study. The investigators included patients treated with gastrectomy for gastric or EGJ cancers at a single center. Severe morbidity was defined as Clavien-Dindo score ≥3.

The following factors are analyzed: age, sex, comorbidity, American Society of Anesthesiologists (ASA) physical status, tobacco and alcohol consumption, body mass index (BMI), hematocrit, serum albumin level, tumor location, the use of preoperative chemotherapy, laparoscopic or open surgery, total or subtotal gastrectomy, duodenal stump closure, multi-organ resection, lymphadenectomy, reconstruction method, T status, lymph node metastasis, and resection margin. The T stage was grouped by T1-T2 and T3-T4 for analysis. Patients will be followed for 5 years after surgery for survival analysis. A multivariate analysis is performed to identify predictors of overall and severe morbidity; and predictors of long-term survival.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 300
• Est. completion date: April 5, 2022
• Est. primary completion date: April 5, 2021
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients treated with a gastrectomy for gastric cancer or esophagogastric cancer.

• Confirmed adenocarcinoma histology.

Exclusion Criteria:

• Histology different from adenocarcinoma.

Related Conditions & MeSH terms

• Esophagogastric Junction Disorder
• Gastric Cancer
• Stomach Neoplasms

Locations

Country	Name	City	State
Chile	Hospital Sotero del Rio	Santiago	RM

Sponsors (1)

Lead Sponsor	Collaborator
Hospital Dr Sotero del Rio

Country where clinical trial is conducted

Chile, 

References & Publications (13)

Bartlett EK, Roses RE, Kelz RR, Drebin JA, Fraker DL, Karakousis GC. Morbidity and mortality after total gastrectomy for gastric malignancy using the American College of Surgeons National Surgical Quality Improvement Program database. Surgery. 2014 Aug;156(2):298-304. doi: 10.1016/j.surg.2014.03.022. Epub 2014 Mar 16. — View Citation

Climent M, Hidalgo N, Vidal Ó, Puig S, Iglesias M, Cuatrecasas M, Ramón JM, García-Albéniz X, Grande L, Pera M. Postoperative complications do not impact on recurrence and survival after curative resection of gastric cancer. Eur J Surg Oncol. 2016 Jan;42(1):132-9. doi: 10.1016/j.ejso.2015.08.163. Epub 2015 Sep 3. — View Citation

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004 Aug;240(2):205-13. — View Citation

Hayashi T, Yoshikawa T, Aoyama T, Ogata T, Cho H, Tsuburaya A. Severity of complications after gastrectomy in elderly patients with gastric cancer. World J Surg. 2012 Sep;36(9):2139-45. doi: 10.1007/s00268-012-1653-6. — View Citation

Kikuchi H, Miyata H, Konno H, Kamiya K, Tomotaki A, Gotoh M, Wakabayashi G, Mori M. Development and external validation of preoperative risk models for operative morbidities after total gastrectomy using a Japanese web-based nationwide registry. Gastric Cancer. 2017 Nov;20(6):987-997. doi: 10.1007/s10120-017-0706-9. Epub 2017 Mar 11. — View Citation

Kim TH, Suh YS, Huh YJ, Son YG, Park JH, Yang JY, Kong SH, Ahn HS, Lee HJ, Slankamenac K, Clavien PA, Yang HK. The comprehensive complication index (CCI) is a more sensitive complication index than the conventional Clavien-Dindo classification in radical gastric cancer surgery. Gastric Cancer. 2018 Jan;21(1):171-181. doi: 10.1007/s10120-017-0728-3. Epub 2017 Jun 8. — View Citation

Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, Cho GS, Kim CY, Yang HK, Park DJ, Song KY, Lee SI, Ryu SY, Lee JH, Lee HJ; Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group. Decreased Morbidity of Laparoscopic Distal Gastrectomy Compared With Open Distal Gastrectomy for Stage I Gastric Cancer: Short-term Outcomes From a Multicenter Randomized Controlled Trial (KLASS-01). Ann Surg. 2016 Jan;263(1):28-35. doi: 10.1097/SLA.0000000000001346. — View Citation

Kubota T, Hiki N, Sano T, Nomura S, Nunobe S, Kumagai K, Aikou S, Watanabe R, Kosuga T, Yamaguchi T. Prognostic significance of complications after curative surgery for gastric cancer. Ann Surg Oncol. 2014 Mar;21(3):891-8. doi: 10.1245/s10434-013-3384-9. Epub 2013 Nov 20. — View Citation

Lee KG, Lee HJ, Yang JY, Oh SY, Bard S, Suh YS, Kong SH, Yang HK. Risk factors associated with complication following gastrectomy for gastric cancer: retrospective analysis of prospectively collected data based on the Clavien-Dindo system. J Gastrointest Surg. 2014 Jul;18(7):1269-77. doi: 10.1007/s11605-014-2525-1. Epub 2014 May 13. — View Citation

Norero E, Vega EA, Diaz C, Cavada G, Ceroni M, Martínez C, Briceño E, Araos F, Gonzalez P, Baez S, Vinuela E, Caracci M, Diaz A. Improvement in postoperative mortality in elective gastrectomy for gastric cancer: Analysis of predictive factors in 1066 patients from a single centre. Eur J Surg Oncol. 2017 Jul;43(7):1330-1336. doi: 10.1016/j.ejso.2017.01.004. Epub 2017 Feb 10. — View Citation

Oñate-Ocaña LF, Cortés-Cárdenas SA, Aiello-Crocifoglio V, Mondragón-Sánchez R, Ruiz-Molina JM. Preoperative multivariate prediction of morbidity after gastrectomy for adenocarcinoma. Ann Surg Oncol. 2000 May;7(4):281-8. — View Citation

Park DJ, Lee HJ, Kim HH, Yang HK, Lee KU, Choe KJ. Predictors of operative morbidity and mortality in gastric cancer surgery. Br J Surg. 2005 Sep;92(9):1099-102. — View Citation

Tokunaga M, Tanizawa Y, Bando E, Kawamura T, Terashima M. Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol. 2013 May;20(5):1575-83. doi: 10.1245/s10434-012-2720-9. Epub 2012 Oct 18. — View Citation

* Note: There are 13 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of patients with severe 30-day or in-hospital morbidity	Clavien 3 or higher complications	Perioperative
Secondary	Median and percentage of patients with long-term survival	5 year survival	5 years