Incidence and grading of complications after gastrectomy for cancer using the GASTRODATA registry a european retrospective observational study

Gian Luca Baiocchi*, Simone Giacopuzzi, Daniel Reim, Guillaume Piessen, Paulo Matos Da Costa, John V. Reynolds, Hans Joachim Meyer, Paolo Morgagni, Ines Gockel, Lucio Lara Santos, Lone Susanne Jensen, Thomas Murphy, Domenico D'Ugo, Riccardo Rosati, Uberto Fumagalli Romario, Maurizio Degiuli, Wojciech Kielan, Stefan Monig, Piotr Kołodziejczyk, Wojciech PolkowskiManuel Pera, Paul M. Schneider, Bas Wijnhoven, Wobbe O. De Steur, Suzanne S. Gisbertz, Henk Hartgrink, Johanna W. Van Sandick, Maristella Botticini, Arnulf H. Holscher, William Allum, Giovanni De Manzoni

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Objective: Utilizing a standardized dataset based on a newly developed list of 27 univocally defined complications, this study analyzed data to assess the incidence and grading of complications and evaluate outcomes associated with gastrectomy for cancer in Europe. Summary Background Data: The absence of a standardized system for recording gastrectomy-associated complications makes it difficult to compare results from different hospitals and countries. Methods: Using a secure online platform (, referral centers for gastric cancer in 11 European countries belonging to the Gastrectomy Complications Consensus Group recorded clinical, oncological, and surgical data, and outcome measures at hospital discharge and at 30 and 90 days postoperatively. This retrospective observational study included all consecutive resections over a 2-year period. Results: A total of 1349 gastrectomies performed between January 2017 and December 2018 were entered into the database. Neoadjuvant chemotherapy was administered to 577 patients (42.8%). Total (46.1%) and subtotal (46.4%) gastrectomy were the predominant resections. D2 or D2+ lymphadenectomy was performed in almost 80% of operations. The overall complications' incidence was 29.8%; 402 patients developed 625 complications, with the most frequent being nonsurgical infections (23%), anastomotic leak (9.8%), other postoperative abnormal fluid from drainage and/or abdominal collections (9.3%), pleural effusion (8.3%), postoperative bleeding (5.6%), and other major complications requiring invasive treatment (5.6%). The median Clavien-Dindo score and ComprehensiveComplications Indexwere IIIa and 26.2, respectively. In-hospital, 30-day, and 90-day mortality were 3.2%, 3.6%, and 4.5%, respectively. Conclusions: The use of a standardized platform to collect European data on perioperative complications revealed that gastrectomy for gastric cancer is still associated with heavy morbidity and mortality. Actions are needed to limit the incidence of, and to effectively treat, the most frequent and most lethal complications.

Original languageEnglish
Pages (from-to)807-813
Number of pages7
JournalAnnals of Surgery
Issue number5
Publication statusPublished - Nov 2020

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