Risk model for distal gastrectomy when treating gastric cancer on the basis of data from 33,917 Japanese patients collected using a nationwide web-based data entry system

Nobuhiro Kurita, Hiroaki Miyata, Mitsukazu Gotoh, Mitsuo Shimada, Satoru Imura, Wataru Kimura, Naohiro Tomita, Hideo Baba, Yuukou Kitagawa, Kenichi Sugihara, Masaki Mori

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Objective: To establish a risk model for distal gastrectomy in Japanese patients with gastric cancer. Background: Risk stratification for distal gastrectomy in Japanese patients with gastric cancer improves surgical outcomes. Methods: The National Clinical Database was constructed for risk determination in gastric cancer-related gastrectomy among Japanese individuals. Data from 33,917 gastric cancer cases (1737 hospitals) were used. The primary outcomes were 30-day and operative mortalities. Data were randomly assigned to risk model development (27,220 cases) and test validation (6697 cases) subsets. Stepwise selection was used for constructing 30-day and operative mortality logistic models. Results: The 30-day, in-hospital, and operative mortality rates were 0.52%, 1.16%, and 1.2%, respectively. The morbidity was 18.3%. The 30-day and operative mortality models included 17 and 21 risk factors, respectively. Thirteen variables overlapped: age, need for total assistance in activities of daily living preoperatively or within 30 days after surgery, cerebrovascular disease history, more than 10% weight loss, uncontrolled ascites, American Society of Anesthesiologists score (≥ class 3), white blood cell count more than 12,000/μL or 11,000/μL, anemia (hemoglobin: males,

Original languageEnglish
Pages (from-to)295-303
Number of pages9
JournalAnnals of Surgery
Issue number2
Publication statusPublished - 2015 Aug 30
Externally publishedYes



  • distal gastrectomy
  • gastric cancer
  • National Clinical Database
  • risk model of mortality
  • surgical outcome

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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