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Relationship between antithrombotic drugs and postoperative outcomes in patients with gastric cancer after gastrectomy: a propensity matching analysis

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Abstract

Background

As there is no consensus on the impact of antithrombotic drugs on post-gastrectomy outcomes in gastric cancer patients, this study aimed to investigate the impact of antithrombotic drugs on postoperative outcomes in these patients after gastrectomy.

Methods

Patients with Stage I–III primary gastric cancer who underwent radical gastrectomy between April 2005 and May 2022 were included. We performed propensity score matching to adjust for patient background and compared bleeding complications. Multivariate analysis with logistic regression analysis was performed to identify risk factors associated with bleeding complications.

Results

Of the 6798 patients, 310 (4.6%) were in the antithrombotic group and 6488 (95.4%) were in the non-antithrombotic group. Twenty-six patients (0.38%) experienced bleeding complications. After matching, the number of patients in each group was 300, with insignificant differences in any factor. A comparison of postoperative outcomes showed no difference in bleeding complications (P = 0.249). In the antithrombotic group, 39 (12.6%) continued drugs, and 271 (87.4%) discontinued them before surgery. After matching, there were 30 and 60 patients, respectively, with no differences in patient background. A comparison of postoperative outcomes showed no differences in bleeding complications (P = 0.551). In multivariate analysis, antithrombotic drug use and continuation of antiplatelet agents were not risk factors for bleeding complications.

Conclusion

Antithrombotic drugs and its continuation may not worsen bleeding complications in patients with gastric cancer after radical gastrectomy. Bleeding complications were rare, and further studies are needed on risk factors for bleeding complications in larger databases.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Ms. Ayumi Shimomugi for data collection and Mr. Nozomi Kurihara for data analysis and interpretation of the results.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Ryota Matsui, Souya Nunobe, Rie Makuuchi, Masaru Hayami, Satoshi Ida, Koshi Kumagai, Manabu Ohashi & Takeshi Sano

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  1. Ryota Matsui
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  2. Souya Nunobe
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  3. Rie Makuuchi
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  4. Masaru Hayami
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  6. Koshi Kumagai
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  7. Manabu Ohashi
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  8. Takeshi Sano
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by RM. The first draft of the manuscript was written by RM and SN and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Souya Nunobe.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1964 and its later versions. Informed consent to be included in the study, or the equivalent, was obtained from all patients (authorization number: 2022-GB-083).

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Matsui, R., Nunobe, S., Makuuchi, R. et al. Relationship between antithrombotic drugs and postoperative outcomes in patients with gastric cancer after gastrectomy: a propensity matching analysis. Gastric Cancer 26, 833–842 (2023). https://doi.org/10.1007/s10120-023-01410-4

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  • DOI: https://doi.org/10.1007/s10120-023-01410-4

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