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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2016

01-12-2016 | Gastrointestinal Oncology

Long-Term Survival in Patients with Postoperative Intra-Abdominal Infectious Complications After Curative Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

Authors: Keiichi Fujiya, MD, Masanori Tokunaga, MD, Keita Mori, MSc, Rie Makuuchi, MD, Yutaka Tanizawa, MD, PhD, Etsuro Bando, MD, PhD, Taiichi Kawamura, MD, PhD, Masanori Terashima, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Special Issue 5/2016

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Abstract

Background

It has been reported that postoperative complications after curative surgery for gastric cancer adversely affect long-term survival; however, postoperative complications may confound other patient characteristics or tumor factors associated with survival outcome. In the present study, covariates were adjusted by propensity score matching to clarify whether postoperative complications truly affect survival outcome.

Methods

The present study was performed on 1541 patients who underwent curative gastrectomy for gastric cancer between 2002 and 2009. Patients were divided into two groups based on the occurrence (174 patients) or absence (1367 patients) of postoperative intra-abdominal infectious complications. Survival outcomes were compared between groups using propensity score matching analysis.

Results

Most clinicopathological characteristics differed significantly between the two groups, but these differences disappeared after propensity score matching. After matching, overall survival was significantly poorer in patients with postoperative intra-abdominal infectious complications [hazard ratio (HR) 1.43, 95 % confidence interval (CI) 1.02–2.00; p = 0.036], as was relapse-free survival (HR 1.42, 95 % CI 1.03–1.96; p = 0.034).

Conclusions

Intra-abdominal infectious complications adversely affected survival outcome when patients were matched by propensity scores, which included demographic data as covariates. Thus, it is important to avoid the development of intra-abdominal infectious complications to improve long-term survival.
Appendix
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Metadata
Title
Long-Term Survival in Patients with Postoperative Intra-Abdominal Infectious Complications After Curative Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis
Authors
Keiichi Fujiya, MD
Masanori Tokunaga, MD
Keita Mori, MSc
Rie Makuuchi, MD
Yutaka Tanizawa, MD, PhD
Etsuro Bando, MD, PhD
Taiichi Kawamura, MD, PhD
Masanori Terashima, MD, PhD, FACS
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue Special Issue 5/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5577-5

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