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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2014

01-03-2014 | Gastrointestinal Oncology

Prognostic Significance of Complications after Curative Surgery for Gastric Cancer

Authors: Takeshi Kubota, MD, PhD, Naoki Hiki, MD, PhD, Takeshi Sano, MD, PhD, Shogo Nomura, MSc, Souya Nunobe, MD, PhD, Koshi Kumagai, MD, PhD, Susumu Aikou, MD, PhD, Ryohei Watanabe, MD, PhD, Toshiyuki Kosuga, MD, PhD, Toshiharu Yamaguchi, MD, PhD

Published in: Annals of Surgical Oncology | Issue 3/2014

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Abstract

Background

Postoperative complications such as anastomotic leakage were reported to be a major independent prognostic factor for long-term survival in gastrointestinal malignancies. This study sought to clarify the prognostic significance of postoperative inflammatory complications specifically for patients with gastric cancer.

Methods

This study included 1,395 patients who underwent curative resection for gastric cancer from 2005 to 2008. Complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) and disease-specific mortality (DSM) were compared between complication and no-complication groups. Presence of complications was modeled by the Cox proportional hazard model for OS and the Fine and Gray competing risk regression model for DSM to assess the correlation between complication and prognosis.

Results

The median follow-up time was 3.1 years. Two hundred seven patients (14.8 %) had complications of grade 2 or higher. Of 131 patients who died within this period, 87 died of gastric cancer. The 3-year OS in the complication group was 84.1 % compared to 93.1 % in the no-complication group (P < 0.0001). The cumulative incidence of DSM was also significantly worse in patients with complications (P < 0.0001). Multivariate analysis identified the same significant increasing risk of complication for both OS (hazard ratio 1.88; 95 % confidence interval 1.26–2.80) and DSM (hazard ratio 1.90; 95 % confidence interval 1.19–3.02).

Conclusions

Postoperative complications that can cause prolonged inflammation have an obvious impact not only on the OS but also on the DSM of patients with gastric cancer even if the tumor is resected curatively.
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Metadata
Title
Prognostic Significance of Complications after Curative Surgery for Gastric Cancer
Authors
Takeshi Kubota, MD, PhD
Naoki Hiki, MD, PhD
Takeshi Sano, MD, PhD
Shogo Nomura, MSc
Souya Nunobe, MD, PhD
Koshi Kumagai, MD, PhD
Susumu Aikou, MD, PhD
Ryohei Watanabe, MD, PhD
Toshiyuki Kosuga, MD, PhD
Toshiharu Yamaguchi, MD, PhD
Publication date
01-03-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3384-9

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