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01-07-2007

Impact of Induction Chemotherapy and Preoperative Chemoradiotherapy on Operative Morbidity and Mortality in Patients with Locoregional Adenocarcinoma of the Stomach or Gastroesophageal Junction

Authors: Kazumasa Fujitani, Jaffer A. Ajani, Christopher H. Crane, Barry W. Feig, Peter W. Pisters, Nora Janjan, Garrett L. Walsh, Stephen G. Swisher, Ara A. Vaporciyan, David Rice, Angela Welch, Jackie Baker, Josephine Faust, Paul F. Mansfield

Published in: Annals of Surgical Oncology | Issue 7/2007

ABSTRACT

Background

Significant tumor downstaging has been achieved in patients with localized gastric or gastroesophageal adenocarcinoma by induction chemotherapy and preoperative chemoradiotherapy (CTX-CTXRT). However, the influence of CTX-CTXRT on operative morbidity and mortality has not yet been clarified. The aim of the present study was to document the frequency and nature of morbidity and mortality after surgery combined with CTX-CTXRT, and identify factors predictive of postoperative complications in patients with localized gastric or gastroesophageal adenocarcinoma.

Methods

A prospectively collected database on 71 consecutive patients who underwent CTX-CTXRT at M.D. Anderson Cancer Center between January 1997 and August 2004 was reviewed. Postoperative morbidity and mortality were investigated, and risk factors for overall complications were identified by multivariate logistic regression analysis.

Results

Overall morbidity and mortality rates were 38.0% (27 patients) and 2.8% (2 patients), respectively. Age greater than 60 years [relative risk 11.3 (95% confidence interval 2.50–50.6)] and body mass index (BMI) of 26 kg/m² or above [relative risk 4.08 (95% confidence interval 1.08 to 15.4)] were significant risk factors for overall complications.

Conclusions

CTX-CTXRT can be performed safely with an acceptable operative morbidity and a low operative mortality rate in patients with gastric or gastroesophageal cancer, with careful consideration of added risk associated with age and obesity.

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Title: Impact of Induction Chemotherapy and Preoperative Chemoradiotherapy on Operative Morbidity and Mortality in Patients with Locoregional Adenocarcinoma of the Stomach or Gastroesophageal Junction
Authors: Kazumasa Fujitani
Jaffer A. Ajani
Christopher H. Crane
Barry W. Feig
Peter W. Pisters
Nora Janjan
Garrett L. Walsh
Stephen G. Swisher
Ara A. Vaporciyan
David Rice
Angela Welch
Jackie Baker
Josephine Faust
Paul F. Mansfield
Publication date: 01-07-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 7/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9198-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Induction Chemotherapy and Preoperative Chemoradiotherapy on Operative Morbidity and Mortality in Patients with Locoregional Adenocarcinoma of the Stomach or Gastroesophageal Junction

ABSTRACT

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ABSTRACT

Background

Methods

Results

Conclusions

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