A quantified risk-scoring system and rating model for postsurgical gastroparesis syndrome in gastric cancer patients

J Surg Oncol. 2017 Sep;116(4):533-544. doi: 10.1002/jso.24691. Epub 2017 Jul 25.

Abstract

Background and objectives: The study aimed to investigate the relationship between obesity and postsurgical gastroparesis syndrome (PGS), and to construct a scoring system and a risk model to identify patients at high risk.

Methods: A total of 634 patients were retrospectively analyzed. Clinical characteristics were evaluated via receiver operating characteristic (ROC) curve analysis. Logistic analysis was performed to determine the independent predictive indicators of PGS. A scoring system consisting of these indicators and a risk-rating model were constructed and evaluated via ROC curve analysis.

Results: Based on the ROC curves, the visceral fat area (VFA) cutoff value for PGS was 94.00. Logistic analysis showed that visceral obesity (VFA ≥ 94.00 cm2 ), the reconstruction technique, and tumor size were independent prognostic factors for PGS. The scoring system could predict PGS reliably with a high area under the ROC curve ([AUC] = 0.769). A high-risk rating had a high AUC (AUC I = 0.56, AUC II = 0.65, and AUC III = 0.77), indicating that the risk-rating model could effectively screen patients at high risk of PGS.

Conclusions: Visceral obesity defined by VFA effectively predicted PGS. Our scoring system may be a reliable instrument for identifying patients most at risk of PGS.

Keywords: postsurgical gastroparesis syndrome; risk model; scoring system; visceral obesity.

MeSH terms

  • Aged
  • Female
  • Gastrectomy / adverse effects*
  • Gastroparesis / diagnosis
  • Gastroparesis / etiology*
  • Humans
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications
  • Postoperative Complications
  • Retrospective Studies
  • Risk Assessment
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*