ニワ　ユキコ   Yukiko Niwa   丹羽　由紀子    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Usefulness of preoperative estimated glomerular filtration rate to predict complications after curative gastrectomy in patients with clinical T2-4 gastric cancer.
掲載誌名	正式名：Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association 略　 称：Gastric Cancer ISSNコード：14363305/14363291
掲載区分	国外
巻・号・頁	20(4),pp.736-743
著者・共著者	Tanaka Yuri, Kanda Mitsuro, Tanaka Chie, Kobayashi Daisuke, Mizuno Akira, Iwata Naoki, Hayashi Masamichi, Niwa Yukiko, Takami Hideki, Yamada Suguru, Fujii Tsutomu, Nakayama Goro, Sugimoto Hiroyuki, Fujiwara Michitaka, Kodera Yasuhiro
発行年月	2017/07
概要	BACKGROUND:Gastrectomy with systemic lymphadenectomy is the standard of care for resectable gastric cancer (GC), but it is sometimes associated with postoperative morbidity. Predicting complications is therefore an essential part of risk management in clinical practice. The renal function is routinely evaluated before surgery by blood examinations to determine dose of medication and infusion. However, the value of various parameters of renal function in prediction of postoperative complications remain unclear.METHODS:We included 315 patients who underwent curative D2 gastrectomy for clinical T2-T4 GC without preoperative treatment, and evaluated the correlation between the incidence of postoperative complications and the indicators of renal function.RESULTS:Forty-three patients experienced clinically relevant postoperative complications. Estimated glomerular filtration rate (eGFR) showed a higher area under the curve for predicting complications compared with urea nitrogen, creatinine, and creatinine clearance. The optimal eGFR cutoff value was 63.2 ml/min/1.73 m2, and eGFR < 63.2 was an independent risk factor for postoperative complications in multivariable analysis (odds ratio 4.67; 95 % confidence interval 2.16-10.5; p < 0.001). Particularly, the incidence of anastomotic leakage was significantly higher in patients with eGFR < 63.2 than those with eGFR ≥ 63.2 (9.4 % vs. 3.5 %). eGFR < 63.2 was also associated with a higher incidence of postoperative complications independent of age, body mass index, operative procedure, and clinical disease stage. Postoperative hospital stay was significantly longer in the eGFR < 63.2 group.CONCLUSIONS:Preoperative eGFR is a simple and useful predictor for complications after gastrectomy in patients with GC and may improve clinical care and the process of obtaining informed consent.
DOI	10.1007/s10120-016-0657-6
PMID	27734274