# Predictive Factors Aiding in the Estimation of Intraoperative Resources in Gastric Cancer Oncologic Surgery

## TL;DR

This study identifies preoperative factors that influence the duration of gastric cancer surgery to help hospitals better manage operating room resources.

## Contribution

The study introduces a quantitative model linking preoperative factors to surgery duration in gastric cancer patients.

## Key findings

- Surgery duration correlates with the number of lymph nodes dissected.
- Tumor histological grade and TNM staging differentially affect surgery duration for curative and palliative cases.
- Male patients show a higher predominance in gastric cancer surgery.

## Abstract

Operating rooms are essential to any hospital, and their efficient management is crucial for ensuring high-quality patient care. When schedules are disrupted, it can lead to delays, staff overwork, increased costs, and dissatisfaction for both patients and healthcare providers. Gastric cancer is a complex disease, and surgery represents the most effective treatment, though the approach may vary depending on the patient’s condition and cancer stage. This study focuses on understanding how preoperative factors, such as blood tests, tumor type, and cancer stage, influence the time needed for surgery. By identifying these factors, we aim to improve the planning and allocation of operating room resources. The findings of this research can help healthcare professionals optimize surgical schedules, reduce unnecessary delays, and ensure better use of hospital resources, ultimately benefiting both patients and medical staff while providing new insights for the broader research community.

Background/Objectives: Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient’s status and tumor staging prove too advanced. Methods: A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). Results: The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative—Group 1, palliative—Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60–192.77)] min), shows a direct correlation with the number of lymph nodes dissected (Surgical duration [min] = 10.67 × No. of lymph nodes removed − 32.25). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). Conclusions: The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as “standard” in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources.