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.

Background: This study aimed to investigate the prevalence of and factors associated with complication after gastrectomy for gastric or esophagogastric cancer compared among surgical purpose (curative Materials and methods: Medical 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. Results: 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 size >5 cm, and operative time >210 min to be independent risk factors for postoperative complication. ASA class III-IV and preoperative serum albumin <3.5 g/dL did not survive multivariate analysis. Conclusion: 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 size >5 cm, and operative time >210 min should be considered high-risk patients.