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Vol. 86. Núm. 6.
Páginas 351-357 (noviembre 2009)
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Vol. 86. Núm. 6.
Páginas 351-357 (noviembre 2009)
Acceso a texto completo
Analysis of postoperative morbidity in patients with gastric adenocarcinoma treated using a protocol of preoperative chemoradiotherapy and surgery
Análisis de la morbilidad postoperatoria en pacientes con adenocarcinoma gástrico tratados según protocolo de quimiorradioterapia preoperatoria y cirugía
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1244
Víctor Valentí
Autor para correspondencia
vvalenti@unav.es

Corresponding author.
, José Luis Hernández-Lizoain, Fernando Martínez Regueira, Aurora Gil, Pablo Martí, Gabriel Zozaya, Álvaro Bueno, Nicolás Pedano, Jorge Arredondo, M. Carmen Beorlegui, Javier Álvarez-Cienfuegos
Departamento de Cirugía General, Universidad de Navarra, Clínica Universidad de Navarra, Pamplona, Spain
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Abstract
Introduction

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.

Material and 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/m2) 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.

Keywords:
Morbidity
Mortality
Stomach cancer
Preoperative chemoradiotherapy
Resumen
Introducción

El impacto del tratamiento neoadyuvante sobre las complicaciones postoperatorias en el cáncer de estómago es motivo de controversia. El objetivo de este trabajo es analizar la morbilidad y la mortalidad postoperatoria en un grupo de pacientes a los que se les había aplicado un protocolo de quimiorradioterapia preoperatoria, así como identificar posibles factores de riesgo que se asocian al desarrollo de complicaciones.

Material y métodos

Entre junio de 2005 y junio de 2008, pacientes diagnosticados de adenocarcinoma gástrico localmente avanzado se intervinieron en nuestro Centro tras haber seguido un protocolo de quimiorradioterapia preoperatoria. Se recogieron prospectivamente los datos sobre morbilidad y mortalidad postoperatoria y se analizaron las variables dependientes relacionadas con los pacientes, con el tipo de intervención y las características tumorales.

Resultados

Se evaluaron 40 pacientes. La morbilidad y la mortalidad global fue del 32,5% (13 pacientes) y del 2,5% (un paciente), respectivamente. Las complicaciones más frecuentes fueron la neumonía en el 12,9% y la sepsis por catéter en el 9,7% de los pacientes. Los factores de riesgo para el desarrollo de complicaciones fueron el índice de masa corporal (>25kg/m2) y la inclusión en la resección del páncreas o del bazo.

Conclusiones

El tratamiento preoperatorio con quimiorradioterapia en pacientes con cáncer de estómago localmente avanzado no incrementa la incidencia de complicaciones postoperatorias. La condición preoperatoria del paciente (índice de masa corporal) y la extensión de la cirugía del bazo y del páncreas son factores pronósticos de complicaciones postoperatorias precoces.

Palabras clave:
Morbilidad
Mortalidad
Cáncer de estómago
Quimiorradioterapia preoperatoria
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