Postoperative complications and their risk factors after gastrectomy for gastric adenocarcinoma
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
F202
Topic of the dissertation
Postoperative complications and their risk factors after gastrectomy for gastric adenocarcinoma
Doctoral candidate
Bachelor of Medicine Emilia Putila
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu
Subject of study
Medicine
Opponent
Docent Mika Ukkonen, Hospital Nova, University of Eastern Finland
Custos
Professor Joonas Kauppila, University of Oulu and OYS
Postoperative complications are common after gastrectomy for gastric cancer
Gastric cancer is one of the most common causes of cancer death worldwide, and it typically has a poor prognosis. The only curative treatment for gastric cancer is gastrectomy, which is known to associate with high number of postoperative complications, reoperations, and mortality. Western studies of complications and their risk factors after gastrectomy for gastric cancer are lacking, especially from a population-based perspective.
Our study was a retrospective nationwide population-based cohort study, which included all patients at least 18 years of age operated for gastric cancer in Finland during 2005-2016. In this study we assessed the incidence and different types of postoperative complications after gastrectomy for gastric cancer, evaluated possible preoperative risk factors predicting postoperative morbidity and compared outcomes after neoadjuvant chemotherapy and upfront surgery. We also compared two proposed classifications in reporting different types of postoperative complications after gastric cancer surgery.
The results of this doctoral study estimated the incidence of postoperative complications after gastrectomy for gastric cancer at 43%, and for major complications at 17% within 90 days after surgery. We showed that neoadjuvant chemotherapy does not increase surgical risk compared to upfront surgery in gastric cancer. After comparing two proposed classifications for reporting postoperative complications, the ECCG classification was more comprehensive and precise. Our results showed that preoperative risk factors for major complications were high ASA-class and advanced stage, whereas risk factors for 90-day mortality were in addition to the above mentioned also older age and comorbidity.
Our doctoral research provides new population-based information on surgical treatment and its risks in gastric cancer for both caregivers and patients. Results on neoadjuvant treatment can inform oncologists and surgeons, and they also inform the clinical treatment guidelines on the potential impact of neoadjuvant treatment in gastric cancer. By recommending ECCG for reporting postoperative complications, we aim for standardizing the reporting of postoperative outcomes, which enables more accurate comparisons between studies. Identifying risk factors for postoperative complications and mortality helps in the patient selection, which can result in improved prognosis, enhanced quality of life and possibly reducing costs by shorter hospital stay.
Our study was a retrospective nationwide population-based cohort study, which included all patients at least 18 years of age operated for gastric cancer in Finland during 2005-2016. In this study we assessed the incidence and different types of postoperative complications after gastrectomy for gastric cancer, evaluated possible preoperative risk factors predicting postoperative morbidity and compared outcomes after neoadjuvant chemotherapy and upfront surgery. We also compared two proposed classifications in reporting different types of postoperative complications after gastric cancer surgery.
The results of this doctoral study estimated the incidence of postoperative complications after gastrectomy for gastric cancer at 43%, and for major complications at 17% within 90 days after surgery. We showed that neoadjuvant chemotherapy does not increase surgical risk compared to upfront surgery in gastric cancer. After comparing two proposed classifications for reporting postoperative complications, the ECCG classification was more comprehensive and precise. Our results showed that preoperative risk factors for major complications were high ASA-class and advanced stage, whereas risk factors for 90-day mortality were in addition to the above mentioned also older age and comorbidity.
Our doctoral research provides new population-based information on surgical treatment and its risks in gastric cancer for both caregivers and patients. Results on neoadjuvant treatment can inform oncologists and surgeons, and they also inform the clinical treatment guidelines on the potential impact of neoadjuvant treatment in gastric cancer. By recommending ECCG for reporting postoperative complications, we aim for standardizing the reporting of postoperative outcomes, which enables more accurate comparisons between studies. Identifying risk factors for postoperative complications and mortality helps in the patient selection, which can result in improved prognosis, enhanced quality of life and possibly reducing costs by shorter hospital stay.
Created 17.11.2025 | Updated 18.11.2025