title: Preoperative clinically inapparent leucopenia in patients undergoing neoadjuvant chemotherapy for locally advanced gastric cancer is not a risk factor for surgical or general postoperative complications.
abstract: BACKGROUND
  Since the recent MAGIC trial neoadjuvant chemotherapy has been considered as treatment option for patients with advanced gastric cancer for tumor-downsizing and increasing R0 resection rates. Morbidity was reported in 45% of the patients treated within this randomized trial. Due to myelotoxicity under chemotherapy a part of the patients might undergo surgery with preoperative leucopenia. As leucopenia causes adverse events such as opportunistic infections and fever, it might be considered as a relevant risk factor in the course of surgical treatment.
  
  
  METHODS
  We analyzed a cohort of neoadjuvantly treated patients (n = 214), which had a clinically inapparent but proven leucopenia (n = 58) before undergoing surgery due to advanced stage gastric cancer.
  
  
  RESULTS
  Statistical analysis by Fisher's exact test showed, that there was no significant effect neither on general (P = 0.191) nor on surgery-dependant postoperative complications (P = 0.75).
  
  
  CONCLUSIONS
  Conclusively patients with clinically inapparent leucopenia after neoadjuvant chemotherapy due to advanced stage gastric cancer can be safely operated on without putting them in danger of relevant surgical complications.
authors.affiliation: Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany. reim@chir.med.tu-muenchen.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Reim
authors.forename: Norbert
authors.initials: N
authors.lastname: Hüser
authors.forename: Daniela
authors.initials: D
authors.lastname: Humberg
authors.forename: Alexander
authors.initials: A
authors.lastname: Novotny
authors.forename: Volker
authors.initials: V
authors.lastname: Assfalg
authors.forename: Edouard
authors.initials: E
authors.lastname: Matevossian
authors.forename: Helmut
authors.initials: H
authors.lastname: Friess
authors.forename: Christoph
authors.initials: C
authors.lastname: Schuhmacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007970:Leukopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery