医学
倾向得分匹配
围手术期
癌症
移植
内科学
外科
胃肠病学
作者
Deok Gie Kim,Won Jun Seo,Gyu Seok Cho,Yoo-Min Kim,Kyu Ha Huh,Jae‐Ho Cheong,Woo Jin Hyung,Myoung Soo Kim,Hyoung‐Il Kim
出处
期刊:Ejso
[Elsevier]
日期:2021-04-21
卷期号:47 (12): 3105-3112
被引量:1
标识
DOI:10.1016/j.ejso.2021.04.017
摘要
Background Details of perioperative outcomes and survival after gastric cancer surgery in prior transplant recipients have received minimal research attention. Methods We performed an observational cohort study using the database of 20,147 gastric cancer patients who underwent gastrectomy at a single gastric cancer center in Korea. Forty-one solid organ recipients [kidney (n = 35), liver (n = 5), or heart (n = 1)] were matched with 205 controls using propensity score matching. Results Operation time, blood loss, and postoperative pain were similar between groups. Short-term complication rates were similar between transplantation and control groups (22.0% vs. 20.1%, P = 0.777). Transplantation group patients with stage 1 gastric cancer experienced no recurrence, while those with stage 2/3 cancer had significantly higher recurrence risk compared to the controls (P = 0.049). For patients with stage 1 cancer, the transplantation group had a significantly higher rate of non-gastric cancer-related deaths compared to the controls (19.2% vs. 1.4%, P = 0.001). For those with stage 2/3 cancer, significantly lower proportion of the transplantation group received adjuvant chemotherapy compared to the control group (26.7% vs. 80.3%, P < 0.001). The transplantation group had a higher (albeit not statistically significant) rate of gastric cancer-related deaths compared to the controls (40.0% vs. 18.0%, P = 0.087). Conclusion Transplant recipients and non-transplant recipients exhibited similar perioperative and short-term outcomes after gastric cancer surgery. From long-term outcome analyses, we suggest active surveillance for non-gastric cancer-related deaths in patients with early gastric cancer, as well as strict oncologic care in patients with advanced cancer, as effective strategies for transplant recipients.
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