Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2019 Sep;23(17):7383-7390. doi: 10.26355/eurrev_201909_18846.
The aim of this study was to investigate the impact of the preoperative American Society of Anesthesiologists-Physical status (ASA-PS) on both the short-term and long-term outcomes in patients with Gastric Cancer (GC).
In a retrospective observational study, a total of 473 GC patients were divided into the following 3 groups: ASA 1, ASA 2, and ASA 3-4.
The ASA 3-4 group included significantly older patients compared to the other groups (p<0.0001). In ASA 1 patients, there was a higher number of lymph nodes dissected (p=0.006), and more patients received adjuvant treatment (p<0.001). In the three groups, no difference regarding the postoperative surgical and medical complications (p=0.29 and p=0.1, respectively) nor in terms of mortality rate (p=0.17) were demonstrated. The multivariate analysis showed that age, tumor stage, number of lymph nodes dissected, positive lymph nodes, adjuvant treatments, and postoperative surgical complications were significant predictive factors for mortality. Five-year overall and disease-free survival for ASA 1, ASA 2, and ASA 3-4 groups was 56%, 57.6%, and 44%, respectively; and 37%, 44.3%, and 39.2%, respectively.
Preoperative ASA-PS alone cannot serve as a direct operative risk indicator for GC patients.
本研究旨在探讨术前美国麻醉医师协会身体状况（ASA-PS）评分对胃癌（GC）患者短期和长期结局的影响。
在一项回顾性观察性研究中，共有 473 名 GC 患者被分为以下 3 组：ASA 1 组、ASA 2 组和 ASA 3-4 组。
ASA 3-4 组患者的年龄明显大于其他两组（p<0.0001）。在 ASA 1 患者中，有更多的淋巴结被切除（p=0.006），并且更多的患者接受了辅助治疗（p<0.001）。在三组中，术后手术和医疗并发症的发生率无差异（p=0.29 和 p=0.1，分别），死亡率也无差异（p=0.17）。多变量分析表明，年龄、肿瘤分期、淋巴结清扫数目、阳性淋巴结、辅助治疗和术后手术并发症是死亡率的显著预测因素。ASA 1、ASA 2 和 ASA 3-4 组的 5 年总生存率和无病生存率分别为 56%、57.6%和 44%；37%、44.3%和 39.2%。
术前 ASA-PS 本身不能作为 GC 患者手术风险的直接指标。
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