Preoperative Chemoradiation Therapy Does Not Increase Risk of Anastomotic Leak in Patients with Gastric Cancer

Publication date: Available online 20 July 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Naruhiko Ikoma, Prajnan Das, Mariela Blum, Jeannelyn S. Estrella, Catherine E. Devine, Xuemei Wang, Keith Fournier, Paul Mansfield, Bruce D. Minsky, Jaffer Ajani, Brian D. Badgwell
IntroductionWe sought to determine whether preoperative chemoradiation therapy or chemotherapy increases the risk of anastomotic leak after gastrectomy in gastric cancer patients without gastroesophageal junction involvement.MethodsWe reviewed data from a prospectively maintained database of patients who underwent gastrectomy at our institution between 2001 and 2016. The incidence of anastomotic leak and symptomatic intra-abdominal fluid collection was determined and tested for associations with the type of preoperative therapy. Risk factors for these complications were identified using univariate and multivariable logistic regression models.ResultsOf 346 included patients, 35% had upfront surgery, 44% had preoperative chemoradiation therapy, and 21% had preoperative chemotherapy. Anastomotic leak and intra-abdominal fluid collection were diagnosed in 3.5% and 7.5% of patients, respectively. Multivariable analysis revealed that concomitant organ resection was the only significant risk factor for anastomotic leak or intra-abdominal fluid collection (p = 0.014). The type of preoperative therapy was not a risk factor for anastomotic leak or intra-abdominal fluid collection.ConclusionAnastomotic leak and intra-abdominal fluid collection were rare after gastrectomy, and neither type of preoperative therapy increased the risk of these complications. Our results add to the existing literature that preoperative therapy, including preoperative chemoradiation therapy, is safe for patients with gastric cancer.

Teaser

In this single institutional retrospective cohort study of 346 patients who underwent gastrectomy at our institution 2001-2016, anastomotic leak and intra-abdominal fluid collection were diagnosed in 3.5% and 7.5% of patients, respectively. Multivariable analysis revealed that concomitant organ resection was the only significant risk factor for anastomotic leak or intra-abdominal fluid collection (p = 0.014). Preoperative chemoradiation therapy was not a risk factor for anastomotic leak or intra-abdominal fluid collection.


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