Trial reportGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2022
Negative impact of intraoperative blood loss on long-term outcome after curative gastrectomy for advanced gastric cancer: exploratory analysis of the JCOG1001 phase III trial.
Trial report in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Article
- Assessment of the safety and efficacy of robotic versus laparoscopic gastrectomy in overweight patients with gastric cancer: a large-scale multicenter cohort study.Surgical endoscopy · 2025Article
- Risk factors as criteria for drain use in gastrectomy: A prospective study.Molecular and clinical oncology · 2025Article
- Escalation and de-escalation in surgery for gastric cancer.International journal of clinical oncology · 2025Review
- Comparison of short- and long-term outcomes for robotic versus laparoscopic gastrectomy in elderly patients with gastric cancer: a multicenter cohort study.Surgical endoscopy · 2025Article
- Comparison of Short-Term Outcomes After Robotic Versus Laparoscopic Radical Gastrectomy for Advanced Gastric Cancer in Elderly Individuals: A Propensity Score-Matching Study.Annals of surgical oncology · 2024Article
- Surgery with minimal bleeding.Annals of gastroenterological surgery · 2024Article
- Essential updates 2021/2022: Perioperative and surgical treatments for gastric and esophagogastric junction cancer.Annals of gastroenterological surgery · 2023Review
- Textbook outcome contributes to long-term prognosis in older adults with gastric cancer.Langenbeck's archives of surgery · 2023Article
- Impact of D2 Gastrectomy for Locally Advanced Gastric Cancer in the Era of Effective Adjuvant Chemotherapy.World journal of surgery · 2023Article
- The Impact of Perioperative Events on Cancer Recurrence and Metastasis in Patients after Radical Gastrectomy: A Review.Cancers · 2022Review
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Authors and funding
14 authors.
Funding
Abstract
backgroundRecent retrospective studies have shown that increased intraoperative blood loss (IBL) during curative gastrectomy for patients with advanced gastric cancer is a negative prognostic indicator for recurrence. However, there are no reliable reports assessing this with a large-scale prospective cohort. This study aimed to evaluate the impact of IBL on long-term outcomes using data from the JCOG1001 phase III trial, which was designed to determine if bursectomy led to improved survival vs. nonbursectomy in patients with cT3/4a gastric cancer.
methodsThis study included 1203 of the 1204 patients enrolled in the JCOG1001. From the tertiles of IBL (196 ml, 400 ml), we divided the patients into three groups: IBL < 200 ml representing small blood loss (SBL, n = 404), 200 ml ≤ IBL < 400 ml representing medium blood loss (MBL, n = 393), and IBL ≥ 400 ml representing large blood loss (LBL, n = 406). The impact of IBL on relapse-free survival (RFS) was evaluated with univariable comparisons and multivariable Cox regression analyses.
resultsThree-year RFS after SBL, MBL, and LBL was 81.7%, 74.8%, and 70.6%, respectively. Multivariable analysis identified IBL, Eastern Cooperative Oncology Group performance status, pT, pN, and postoperative adjuvant chemotherapy as independent predictors of RFS. Compared with SBL as a reference, the hazard ratios of MBL and LBL were 1.461 (P = 0.012) and 1.520 (P = 0.009), respectively.
conclusionsBased on the analysis of data from a large-scale prospective study, an IBL of ≥ 200 ml after curative surgery for patients with cT3/4a gastric cancer was an independent predictor of reduced RFS.
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