[Analysis of postoperative morbidity in patients with gastric adenocarcinoma treated using a protocol of preoperative chemoradiotherapy and surgery].
BACKGROUND
The impact of neoadjuvant treatment on the postoperative complications in stomach cancer is a subject of controversy. The aim of this study is to analyse the post-surgical morbidity and mortality in a group of patients who were treated using a chemoradiotherapy protocol before surgery, as well as to identify the possible risk factors that may be associated with the development of complications.


METHODS
Patients diagnosed with locally advanced gastric adenocarcinoma between June 2005 and June 2008 were operated on in our Centre after having followed a preoperative chemoradiotherapy protocol. Data on postoperative morbidity and mortality were collected retrospectively and the dependent variables associated with the patients, the type of intervention and the tumour characteristics were analysed.


RESULTS
A total of 40 patients were evaluated. The overall morbidity and mortality was 32.5% (13 patients) and 2.5% (1 patient), respectively. The most frequent complications were pneumonia in 12.9% and sepsis due to the catheter in 9.7% of the patients. The risk factors for the development of complications were the body mass index (BMI 25 kg/m(2)) and the inclusion of the pancreas and/or spleen in the resection.


CONCLUSIONS
Preoperative treatment with chemoradiotherapy in patients with locally advanced stomach cancer does not increase the incidence of post-surgical complication. The preoperative condition of the patient (BMI) and extending the surgery to the spleen and pancreas are prognostic factors of early postoperative complications.
Valentí
Víctor
V
Departmento de Cirugía General, Universidad de Navarra, Clínica Universidad de Navarra, Pamplona, España. vvalenti@unav.es
Hernández-Lizoain
José Luis
JL
Martínez Regueira
Fernando
F
Gil
Aurora
A
Martí
Pablo
P
Zozaya
Gabriel
G
Bueno
Alvaro
A
Pedano
Nicolás
N
Arredondo
Jorge
J
Beorlegui
M Carmen
MC
Alvarez-Cienfuegos
Javier
J
D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D000368:Aged; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011300:Preoperative Care; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*