A Decade Experience of Gastric Cancer Surgery at a High-Volume Tertiary Centre in Australia, a Low-Volume Country.

Background: Gastrectomy is the mainstay curative treatment of gastric cancer. In Australia, the incidence of gastric cancer is much lower than other countries, especially the East. Consequently, there is a paucity of surgical outcomes reported for gastric cancer surgery in Australia. The aims of this study were 1) to report the surgical outcomes of all gastric cancer patients treated by gastrectomy at our single tertiary centre in Australia, 2) to compare the outcomes to other Australian and international centres and 3) to evaluate influence of time period, age and neoadjuvant chemotherapy (NAC) on surgical outcomes. Methods: A retrospective review of a prospectively maintained operations database identified 160 gastrectomy patients at a single tertiary centre in Australia between 2005 to 2014. They were screened against established inclusion and exclusion criteria. Demographic, preoperative, operative, postoperative and histopathological outcomes were compiled and analysed as categorical and continuous data. Results: Overall 102 gastrectomy patients curatively treated for gastric cancer satisfied criteria for inclusion into this study. Postoperative complications were observed in 29 (28%) patients. No mortality events were observed from operation to thirty days after hospital discharge. There was significantly increased postoperative stay in intensive care unit (p=0.00) and hospital (p=0.01) over time. NAC was administered to 39 (38%) patients and showed significant histopathological response (p=0.01) on specimen study. Conclusion: The surgical outcomes of the gastrectomy operations for gastric cancer performed at our centre compare favourably to the reported outcomes of other Australian and international centres. A prospective, long-­term, multi-­institutiona