Negative impact of intraoperative blood loss on long-term outcome after curative gastrectomy for advanced gastric cancer: exploratory analysis of the JCOG1001 phase III trial

Background Recent retrospective studies have shown that increased intraoperative blood loss (IBL) during curative gastrectomy for patients with advanced gastric cancer is a negative prognostic indicator for recurrence. However, there are no reliable reports assessing this with a large-scale prospect...

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Published in:Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 2022-03, Vol.25 (2), p.459-467
Main Authors: Misawa, Kazunari, Kurokawa, Yukinori, Mizusawa, Junki, Takiguchi, Shuji, Doki, Yuichiro, Makino, Shigeto, Choda, Yasuhiro, Takeno, Atsushi, Tokunaga, Masanori, Sano, Takeshi, Sasako, Mitsuru, Yoshikawa, Takaki, Terashima, Masanori
Format: Article
Language:English
Subjects:
Abdominal Surgery
Blood
Blood Loss, Surgical
Bursectomy
Cancer Research
Chemotherapy
Gastrectomy
Gastric cancer
Gastroenterology
Gastrointestinal surgery
Humans
Medicine
Medicine & Public Health
Oncology
Original Article
Patients
Prognosis
Prospective Studies
Retrospective Studies
Stomach Neoplasms - drug therapy
Stomach Neoplasms - surgery
Surgical Oncology
Survival
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Summary:Background Recent retrospective studies have shown that increased intraoperative blood loss (IBL) during curative gastrectomy for patients with advanced gastric cancer is a negative prognostic indicator for recurrence. However, there are no reliable reports assessing this with a large-scale prospective cohort. This study aimed to evaluate the impact of IBL on long-term outcomes using data from the JCOG1001 phase III trial, which was designed to determine if bursectomy led to improved survival vs. nonbursectomy in patients with cT3/4a gastric cancer. Methods This study included 1203 of the 1204 patients enrolled in the JCOG1001. From the tertiles of IBL (196 ml, 400 ml), we divided the patients into three groups: IBL 
ISSN:1436-3291
1436-3305
DOI:10.1007/s10120-021-01266-6