The impact of neoadjuvant treatment on early postoperative complications and pathological outcomes in gastric cancer patients: A retrospective cohort study

Neoadjuvant treatment (NAT) has been increasingly used for locally advanced gastric cancer considering the potential for systemic dissemination and inoperability of the disease. This study aimed to evaluate the effects of NAT on the early postoperative complications and pathological outcomes in patients undergoing surgery for gastric cancer. We included patients with gastric cancer who underwent surgery at a tertiary care center between January 2014 and December 2021. The patients were divided into NAT receiving (Group I) and non-receiving (Group II) groups. Demographic data, clinical characteristics, intraoperative and postoperative complications, and pathological findings were retrospectively analyzed and compared between the 2 groups. Among the 186 patients, 27% (n = 51) were in group I and 73% (n = 135) were in group II. The 2 groups were comparable in terms of their demographic characteristics. There were no significant differences in surgery time (P = .932), intraoperative complication rates (P = .993), postoperative complications (Clavien-Dindo grade ≥ III) (P = .549), or anastomotic leakage rates (P > .05) between the groups. Both groups had a similar median number of total harvested lymph nodes (n = 28, P = .917), metastatic lymph nodes (n = 6, P = .509), and R0 resection rates (94% vs 95, 6% P = .707). Subgroup analysis revealed no significant difference in early postoperative complication rates between patients receiving chemotherapy and chemoradiotherapy (P = .330). Neoadjuvant treatment did not appear to increase the risk of early postoperative complications or affect the extent of lymphadenectomy in patients who underwent curative surgery for gastric cancer. These findings support the surgical safety and feasibility of NAT, particularly in multidisciplinary settings. A longer follow-up is required to assess the impact on survival outcomes and long-term complications.