Predictive Factors Aiding in the Estimation of Intraoperative Resources in Gastric Cancer Oncologic Surgery

<b>Background/Objectives:</b> Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient's status and tumor staging prove too advanced. <b>Methods:</b> A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). <b>Results:</b> The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative-Group 1, palliative-Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60-192.77)] min), shows a direct correlation with the number of lymph nodes dissected (<i>Surgical duration [min] = 10.67 × No. of lymph nodes removed - 32.25</i>). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). <b>Conclusions:</b> The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as "standard" in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources.

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Journal
Cancers
Published
2025-06-18
DOI
https://doi.org/10.3390/cancers17122038
Primary Topic
Gastric Cancer Management and Outcomes
Type
article
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article

Predictive Factors Aiding in the Estimation of Intraoperative Resources in Gastric Cancer Oncologic Surgery

Cristina Dehelean, Andreea-Adriana Neamțu, Sorin Dema, Ionuţ Flaviu Faur et al.
2 links
Cancers
Gastric Cancer Management and Outcomes
article

Predictive Factors Aiding in the Estimation of Intraoperative Resources in Gastric Cancer Oncologic Surgery

Cristina Dehelean, Andreea-Adriana Neamțu, Sorin Dema, Ionuţ Flaviu Faur, Andrei Ardelean, Bogdan Totolici, Alexandru Blidișel, Mihai Cătălin Roșu, Carmen Neamţu, Răzvan-Ovidiu Pop-Moldovan, Valentin-Cristian Iovin
article en

Abstract

<b>Background/Objectives:</b> Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient's status and tumor staging prove too advanced. <b>Methods:</b> A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). <b>Results:</b> The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative-Group 1, palliative-Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60-192.77)] min), shows a direct correlation with the number of lymph nodes dissected (<i>Surgical duration [min] = 10.67 × No. of lymph nodes removed - 32.25</i>). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). <b>Conclusions:</b> The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as "standard" in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources.

CancersVol. 17(12)
Clinical Emergency Hospital Bucharest (RO), Arad County Clinical Hospital (RO), Spitalul Clinic Judeţean de Urgenţă "Pius Brînzeu" Timişoara (RO), Victor Babeș University of Medicine and Pharmacy Timișoara (RO), Vasile Goldis Western University of Arad (RO)
Openalex Percentile: Top 77%
Gastric Cancer Management and Outcomes
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