Factors associated with complication after gastrectomy for gastric or esophagogastric cancer compared among surgical purpose, surgical extent, and patient age: Retrospective study from a high volume center in Thailand

This study aimed to investigate the prevalence of and factors associated with complication after gastrectomy for gastric or esophagogastric cancer compared among surgical purpose (curativeMedical records of patients with gastric/esophagogastric junction cancer who underwent gastrectomy at Siriraj Hospital (Bangkok, Thailand) during January 2005 to June 2017 were retrospectively reviewed. Complications were compared and risk factors were identified.Of 454 included patients, 84.8% and 15.2% underwent curative and palliative gastrectomy, respectively. Overall postoperative morbidity was not significantly different between groups. Extended and total gastrectomy demonstrated a trend towards higher postoperative complication. Age ≥70 years in curative gastrectomy, and age ≥80 years in palliative gastrectomy were significantly associated with increased postoperative complications (OR: 4.67, 95%CI: 1.46-14.9 and OR: 17.50, 95%CI: 1.22-250.36, respectively). Multivariate analysis revealed age ≥70 years, coronary artery disease (CAD), tumor size5 cm, and operative time210 min to be independent risk factors for postoperative complication. ASA class III-IV and preoperative serum albumin3.5 g/dL did not survive multivariate analysis.Purpose and extent of surgery were not associated with incidence and severity of postoperative morbidity. Age ≥70 years was associated with higher postoperative complication after curative gastrectomy, and age ≥80 years was associated with adverse events after palliative gastrectomy. Patients with age ≥70 years, CAD, tumor size5 cm, and operative time210 min should be considered high-risk patients.