Preoperative clinically inapparent leucopenia in patients undergoing neoadjuvant chemotherapy for locally advanced gastric cancer is not a risk factor for surgical or general postoperative complications

Background: Since the recent MAGIC trial neoadjuvant chemotherapy has been considered as treatment option for patients with advanced gastric cancer for tumor-downsizing and increasing R0 resection rates. Morbidity was reported in 45% of the patients treated within this randomized trial. Due to myelotoxicity under chemotherapy a part of the patients might undergo surgery with preoperative leucopenia. As leucopenia causes adverse events such as opportunistic infections and fever, it might be considered as a relevant risk factor in the course of surgical treatment. Patients and Methods: We analyzed a cohort of neoadjuvantly treated patients (n=214), which had a clinically inapparent but proven leucopenia (n=58) before undergoing surgery due to advanced stage gastric cancer. Results: Statistical analysis by Fisher's exact test showed, that there was no significant effect neither on general (P=0.191) nor on surgery-dependant postoperative complications (P=0.75). Conclusion: Conclusively patients with clinically inapparent leucopenia after neoadjuvant chemotherapy due to advanced stage gastric cancer can be safely operated on without putting them in danger of relevant surgical complications.