Comorbidity in predicting surgical outcomes for gastric cancer
Objective: The present study aimed to analyze the treatment outcomes and develop a predictive model of surgical treatment for gastric cancer, taking into account the comorbidity of patients. Material and Methods. The treatment outcomes were studied in 477 (100 %) gastric cancer patients. Patients we...
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| Format: | Article |
| Language: | Russian |
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Russian Academy of Sciences, Tomsk National Research Medical Center
2023-09-01
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| Series: | Сибирский онкологический журнал |
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| Online Access: | https://www.siboncoj.ru/jour/article/view/2672 |
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| author | V. A. Suvorov S. I. Panin N. V. Kovalenko V. V. Zhavoronkova M. P. Postolov S. E. Tolstopyatov A. A. Panina Sh. R. Suleymanov E. Sh. Vezirov I. A. Peshkurova |
| author_facet | V. A. Suvorov S. I. Panin N. V. Kovalenko V. V. Zhavoronkova M. P. Postolov S. E. Tolstopyatov A. A. Panina Sh. R. Suleymanov E. Sh. Vezirov I. A. Peshkurova |
| author_sort | V. A. Suvorov |
| collection | DOAJ |
| description | Objective: The present study aimed to analyze the treatment outcomes and develop a predictive model of surgical treatment for gastric cancer, taking into account the comorbidity of patients. Material and Methods. The treatment outcomes were studied in 477 (100 %) gastric cancer patients. Patients were stratifed into two groups according to the Age-Adjusted Charlson Comorbidity Index (ACCI) (0–4 points – 311 (65,2 %), more than 4 points – 166 (34,8 %) patients). Two hundred and seventy six patients (57.9 %) underwent distal or total gastrectomy, 178 (37.3 %) total gastrectomy, 19 (4 %) minimally invasive gastrectomy, and 4 (0.8 %) patients underwent extirpation of the gastric stump. The construction of models for the prognosis of surgical treatment was carried out using binary logistic regression, the comparison of models – by analyzing error curves (ROC-analysis). Results. The incidence rate of postoperative complications (grade III-V) according to the Clavien-Dindo classifcation was signifcantly higher in group 2 (9.9 %, 47/477) compared to group 1 (2.1 %, 10/477) (χ2 =64.79, p<0.001; OR 11.9 [5.82–24.3]). Postoperative mortality rate was 0.2 % (1/477) in group 1 and 1.9 % (9/477) in group 2 (χ2 =13.7, p<0.001; OR 17.8 [2.23–142]). In a comparative analysis, the prognostic model, taking into account the ACCI of the patient, allowed prediction of the development of postoperative grade III–V complications according to the Clavien-Dindo with the greatest accuracy. The area under the curve (AUC) was 0.921 ± 0.01 (95 % CI: 0,96–0,998), sensitivity – 71.9 %, specifcity – 99.8 %, diagnostic accuracy – 96.4 %. Conclusion. The inclusion of comorbidity in gastric cancer patients in the predictive concept makes it possible to improve the accuracy of prediction of postoperative complications of III–V grade according to Clavien-Dindo. |
| format | Article |
| id | doaj-art-bbb4932bcffd4339b7856b86efd5dd3b |
| institution | Kabale University |
| issn | 1814-4861 2312-3168 |
| language | Russian |
| publishDate | 2023-09-01 |
| publisher | Russian Academy of Sciences, Tomsk National Research Medical Center |
| record_format | Article |
| series | Сибирский онкологический журнал |
| spelling | doaj-art-bbb4932bcffd4339b7856b86efd5dd3b2025-08-20T03:43:40ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682023-09-0122451310.21294/1814-4861-2023-22-4-5-131137Comorbidity in predicting surgical outcomes for gastric cancerV. A. Suvorov0S. I. Panin1N. V. Kovalenko2V. V. Zhavoronkova3M. P. Postolov4S. E. Tolstopyatov5A. A. Panina6Sh. R. Suleymanov7E. Sh. Vezirov8I. A. Peshkurova9Volgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaVolgograd State Medical University of the Ministry of Health of RussiaObjective: The present study aimed to analyze the treatment outcomes and develop a predictive model of surgical treatment for gastric cancer, taking into account the comorbidity of patients. Material and Methods. The treatment outcomes were studied in 477 (100 %) gastric cancer patients. Patients were stratifed into two groups according to the Age-Adjusted Charlson Comorbidity Index (ACCI) (0–4 points – 311 (65,2 %), more than 4 points – 166 (34,8 %) patients). Two hundred and seventy six patients (57.9 %) underwent distal or total gastrectomy, 178 (37.3 %) total gastrectomy, 19 (4 %) minimally invasive gastrectomy, and 4 (0.8 %) patients underwent extirpation of the gastric stump. The construction of models for the prognosis of surgical treatment was carried out using binary logistic regression, the comparison of models – by analyzing error curves (ROC-analysis). Results. The incidence rate of postoperative complications (grade III-V) according to the Clavien-Dindo classifcation was signifcantly higher in group 2 (9.9 %, 47/477) compared to group 1 (2.1 %, 10/477) (χ2 =64.79, p<0.001; OR 11.9 [5.82–24.3]). Postoperative mortality rate was 0.2 % (1/477) in group 1 and 1.9 % (9/477) in group 2 (χ2 =13.7, p<0.001; OR 17.8 [2.23–142]). In a comparative analysis, the prognostic model, taking into account the ACCI of the patient, allowed prediction of the development of postoperative grade III–V complications according to the Clavien-Dindo with the greatest accuracy. The area under the curve (AUC) was 0.921 ± 0.01 (95 % CI: 0,96–0,998), sensitivity – 71.9 %, specifcity – 99.8 %, diagnostic accuracy – 96.4 %. Conclusion. The inclusion of comorbidity in gastric cancer patients in the predictive concept makes it possible to improve the accuracy of prediction of postoperative complications of III–V grade according to Clavien-Dindo.https://www.siboncoj.ru/jour/article/view/2672stomach cancerpostoperative complicationscomorbidityage-adjusted charlson comorbidity indexprognostic model |
| spellingShingle | V. A. Suvorov S. I. Panin N. V. Kovalenko V. V. Zhavoronkova M. P. Postolov S. E. Tolstopyatov A. A. Panina Sh. R. Suleymanov E. Sh. Vezirov I. A. Peshkurova Comorbidity in predicting surgical outcomes for gastric cancer Сибирский онкологический журнал stomach cancer postoperative complications comorbidity age-adjusted charlson comorbidity index prognostic model |
| title | Comorbidity in predicting surgical outcomes for gastric cancer |
| title_full | Comorbidity in predicting surgical outcomes for gastric cancer |
| title_fullStr | Comorbidity in predicting surgical outcomes for gastric cancer |
| title_full_unstemmed | Comorbidity in predicting surgical outcomes for gastric cancer |
| title_short | Comorbidity in predicting surgical outcomes for gastric cancer |
| title_sort | comorbidity in predicting surgical outcomes for gastric cancer |
| topic | stomach cancer postoperative complications comorbidity age-adjusted charlson comorbidity index prognostic model |
| url | https://www.siboncoj.ru/jour/article/view/2672 |
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