Annals of Surgical Oncology

, Volume 23, Supplement 2, pp 222–229 | Cite as

Preoperative Cardiac Risk Assessment and Surgical Outcomes of Patients with Gastric Cancer

  • Sohei Matsumoto
  • Tomoyoshi Takayama
  • Kohei Wakatsuki
  • Tetsuya Tanaka
  • Kazuhiro Migita
  • Masahiro Ito
  • Hiroshi Nakade
  • Tomohiro Kunishige
  • Yoshiyuki Nakajima
Gastrointestinal Oncology

Abstract

Purpose

To evaluate the incidence of major adverse cardiac events (MACE) and long-term surgical outcomes after gastrectomy for gastric cancer using the revised cardiac risk index (RCRI), which is based on preoperative insulin use, serum creatinine >2.0 mg/dL, and history of ischemic or congestive heart failure or cerebrovascular disease.

Methods

We allocated 1000 patients who underwent elective gastrectomy to three groups with ≥3 (group A, n = 32), 2 (group B, n = 142), or 1 (group C, n = 826) of these factors and compared surgical complications and prognoses.

Results

Groups A and B had older patients than group C. Group B had more male patients than groups A and C. Tumor staging and gastrectomy type were similar among all groups. D1 lymph node dissection was more frequent in group A than in groups B or C. The incidence of MACE in groups A, B, and C was 25.0, 9.9, and 1.1 %, respectively. RCRI was associated with MACE. Furthermore, the incidence of pneumonia and in-hospital mortality was associated with RCRI risk factors. However, the incidence of anastomotic leakage, intra-abdominal abscess, wound infection, and pancreas-related infection were similar among the groups. The 5-year overall survival rates of the three groups were 44.3, 65.2, and 80.8 %, which were significantly different.

Conclusions

Patients with RCRI factors have an increased risk of MACE, pneumonia, and higher mortality after gastrectomy; thus, careful patient selection and meticulous perioperative care are crucial for successful gastrectomy.

Keywords

Gastric Cancer Gastric Cancer Patient Major Adverse Cardiac Event Noncardiac Surgery Proximal Gastrectomy 

Notes

Disclosure

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Sohei Matsumoto
    • 1
  • Tomoyoshi Takayama
    • 1
  • Kohei Wakatsuki
    • 1
  • Tetsuya Tanaka
    • 1
  • Kazuhiro Migita
    • 1
  • Masahiro Ito
    • 1
  • Hiroshi Nakade
    • 1
  • Tomohiro Kunishige
    • 1
  • Yoshiyuki Nakajima
    • 1
  1. 1.Department of SurgeryNara Medical University School of MedicineKashiharaJapan

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