Prognostic value of anticoagulants in resectable gastric cancer

Abstract Background: The safety and feasibility of perioperative anticoagulation remains unclear and controversial. In this study, we aim to explored whether postoperative anticoagulation can improve long-term survival in patients undergoing radical gastrectomy. Methods: We retrospectively enrolled 1486 patients diagnosed with primary gastric cancer (GC) and undergoing radical resection in our medical center between January 2015 and February 2018. Patients were grouped into anticoagulation group and non-anticoagulation group based on postoperative anticoagulant therapy, and clinicopathological features were collected and compared. The correlation between parameters and survival was assessed using the Kaplan-Meier method and univariate and multivariate COX regression models. Forest plots were constructed based on subgroup analysis and multivariate Cox regression analysis. Results: Among the 1486 patients, 513 (34.5%) received postoperative anticoagulation therapy. In multivariate survival analysis, non-anticoagulation significantly reduced overall survival (OS), but not disease-free survival (DFS). Furthermore, elevated plasma CEA, CA19-9, lower erythrocyte and lymphocyte counts, and advanced N stage were also shown to be independent poor prognostic factors for OS, and they were also independent prognostic factors for DFS, in addition to lymphocyte counts. Conclusions: Anticoagulation therapy after radical gastrectomy can significantly improve the OS of GC patients.