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Perioperative, short-, and long-term outcomes of gastric cancer surgery: Propensity score-matched analysis of patients with or without prior solid organ transplantation

Authors
 Deok Gie Kim  ;  Won Jun Seo  ;  Minah Cho  ;  Yoo-Min Kim  ;  Kyu Ha Huh  ;  Jae-Ho Cheong  ;  Woo Jin Hyung  ;  Myoung Soo Kim  ;  Hyoung-Il Kim 
Citation
 EJSO, Vol.47(12) : e3105-e3112, 2021-12 
Journal Title
EJSO
ISSN
 0748-7983 
Issue Date
2021-12
Keywords
Gastric cancer ; Organ transplantation ; Transplant recipients
Abstract
Background: Details of perioperative outcomes and survival after gastric cancer surgery in prior transplant recipients have received minimal research attention.

Methods: We performed an observational cohort study using the database of 20,147 gastric cancer patients who underwent gastrectomy at a single gastric cancer center in Korea. Forty-one solid organ recipients [kidney (n = 35), liver (n = 5), or heart (n = 1)] were matched with 205 controls using propensity score matching.

Results: Operation time, blood loss, and postoperative pain were similar between groups. Short-term complication rates were similar between transplantation and control groups (22.0% vs. 20.1%, P = 0.777). Transplantation group patients with stage 1 gastric cancer experienced no recurrence, while those with stage 2/3 cancer had significantly higher recurrence risk compared to the controls (P = 0.049). For patients with stage 1 cancer, the transplantation group had a significantly higher rate of non-gastric cancer-related deaths compared to the controls (19.2% vs. 1.4%, P = 0.001). For those with stage 2/3 cancer, significantly lower proportion of the transplantation group received adjuvant chemotherapy compared to the control group (26.7% vs. 80.3%, P < 0.001). The transplantation group had a higher (albeit not statistically significant) rate of gastric cancer-related deaths compared to the controls (40.0% vs. 18.0%, P = 0.087).

Conclusion: Transplant recipients and non-transplant recipients exhibited similar perioperative and short-term outcomes after gastric cancer surgery. From long-term outcome analyses, we suggest active surveillance for non-gastric cancer-related deaths in patients with early gastric cancer, as well as strict oncologic care in patients with advanced cancer, as effective strategies for transplant recipients.
Full Text
https://www.sciencedirect.com/science/article/pii/S0748798321004455?
DOI
10.1016/j.ejso.2021.04.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Yoo Min(김유민)
Kim, Hyoung Il(김형일) ORCID logo https://orcid.org/0000-0002-6134-4523
Seo, Won Jun(서원준)
Cheong, Jae Ho(정재호) ORCID logo https://orcid.org/0000-0002-1703-1781
Cho, Minah(조민아) ORCID logo https://orcid.org/0000-0003-3011-5813
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187344
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