Evidence map›Paper›PMID 42525320›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2026

Modified transferrin saturation is associated with postoperative complications in patients undergoing curative gastrectomy for gastric cancer.

Chishou Mitsuura, Satoshi Ida, Hiroki Tsubakihara, Kohei Yamashita, Kojiro Eto, Chihiro Matsumoto, Keisuke Kosumi, Kazuto Harada, Yuji Miyamoto, Masaaki Iwatsuki

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Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Chishou MitsuuraDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Satoshi IdaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Hiroki TsubakiharaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Kohei YamashitaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Kojiro EtoDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Chihiro MatsumotoDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Keisuke KosumiDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Kazuto HaradaDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Yuji MiyamotoDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Masaaki IwatsukiDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. maiwa217@kumamoto-u.ac.jp.ORCID http://orcid.org/0000-0002-0886-4618

Funding

Japan Agency for Medical Research and Development JP266f0137011
6 · The paper itself

Abstract

backgroundSurgical complications after gastrectomy significantly impact recovery and long-term prognosis. While iron status influences outcomes, the conventional 20% transferrin saturation (TSAT) threshold ignores sex-specific physiological differences. We developed a modified TSAT (mTSAT) based on sex and anemia status and evaluated its value in predicting complications.

methodsWe retrospectively analyzed 243 patients who underwent curative gastrectomy. Optimal TSAT cut-off values for predicting complications classified as Clavien-Dindo grade II or higher were determined using receiver operating characteristic curves stratified by sex and anemia status. Predictive performance was compared between mTSAT and the conventional 20% threshold using the corrected Akaike Information Criterion.

resultsThe optimal mTSAT cut-offs were 22.2% for men and 14.2% for women. The mTSAT model demonstrated an improved fit compared with the conventional threshold. The low mTSAT group (mTSAT below the sex-specific cut-off) comprised 78 patients and exhibited a significantly higher incidence of complications than the normal mTSAT group, particularly anastomotic leakage and delayed gastric emptying/ileus. Moreover, postoperative hospital stay was significantly longer in this group. In the primary multivariable analysis, low mTSAT was significantly associated with postoperative complications, whereas the conventional 20% threshold was not. After additional adjustment for clinical stage and surgical approach, the association was attenuated and no longer reached statistical significance.

conclusionsPreoperative low mTSAT was associated with an increased risk of postoperative complications. Rather than a standalone predictor, mTSAT functions as a valuable composite clinical indicator reflecting stage-related systemic vulnerability, surgical invasiveness, and underlying malnutrition or iron deficiency.

Indexed as

GastrectomyPostoperative ComplicationsStomach NeoplasmsTransferrinAgedAnemiaFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisRetrospective StudiesTransferrinGastric cancerIron deficiencyModified transferrin saturationPersonalized risk stratificationPostoperative complications

Identifiers

PMID42525320

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.