Are postoperative fever and/or septic complications prognostic factors in colorectal cancer resected for cure?

Fucini, Claudio; Bandettini, L; D'Elia, Massimo; Filipponi, Franco; Herd-Smith, Andrea

doi:10.1007/bf02552653

Cited by 17 publications

(14 citation statements)

References 5 publications

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“…Fucini et al (1985), Sauven et al (1989) and Kressner et al (2002) reported increased local recurrence in colorectal cancers after perineal wound infection similar to the report of Varty et al (1994). They found no difference in overall survival and concluded that there was no overall survival difference for patients with or without postoperative sepsis following excision of colorectal cancer.…”

Section: Discussionsupporting

confidence: 53%

Postoperative wound complications and systemic recurrence in breast cancer

et al. 2007

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Many factors involved in wound healing can stimulate tumour growth in the experimental setting. This study examined the relationship between wound complications and the development of systemic recurrence after treatment of primary breast cancer. One thousand and sixty-five patients diagnosed with operable primary invasive breast cancer between 1994 and 2001 were assessed for development of systemic recurrence according to whether or not a wound complication occurred after surgery, with a median follow-up of 54 months (range 15-119). There were 93 wound complications (9%). There was a statistically significant greater risk of developing systemic recurrence in patients with wound problems than those without (hazard ratio (HR) 2.87; 95% CI: 1.97, 4.18; Po0.0001). This remained in a multivariate analysis after adjustment for case mix variables, including Nottingham Prognostic Index (NPI) and oestrogenprogesterone receptor status (HR: 2.52; 95% CI: 1.69, 3.77; Po0.0001). In the good prognostic NPI group, 4 out of 27 patients (15%) with wound problems vs 11 out of 334 (3%) without wound problems developed systemic recurrence. The corresponding figures were 10 out of 35 (29%) vs 48 out of 412 (12 %) in the moderate prognostic group and 18 out of 29 (62%) vs 75 out of 199 (38%) in the poor prognostic group. In 29 patients NPI could not be calculated. Smokers at the time of diagnosis were more likely to develop metastatic disease than the non-smokers (HR: 1.50; 95% CI: 1.04, 2.15; P ¼ 0.03) after adjustment for other factors. The results suggest that patients with wound complications at primary surgery have increased rates of systemic recurrence of breast cancer.

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Section: Discussionsupporting

confidence: 53%

Postoperative wound complications and systemic recurrence in breast cancer

et al. 2007

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“…Increasing evidence has shown that postoperative complications due to infection, especially those caused by anastomotic leakage after colorectal surgery, were significantly associated with a negative long-term outcome (3,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Postoperative infections are associated with adverse outcome after resection with curative intent for colorectal cancer

Tsujimoto¹,

Ueno²,

Hashiguchi³

et al. 2010

Oncology Letters

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Abstract. this study focused on the impact of post-operative infection on patient outcome after resection with curative intent for colorectal cancer. Postoperative surgical and medical complications have been implicated as a negative predictor of long-term outcome in various malignancies. We studied a population of 1083 patients who underwent resection with curative intent for colorectal cancer. these patients were divided into 2 groups based on the occurrence (65 patients, 6%) or absence (1018 patients, 94%) of postoperative complications due to infection. We investigated the demographic and clinicopathological features of each patient with and without postoperative infectious complications, as well as the impact of postoperative infection on long-term survival. results showed that patients with postoperative infectious complications had diabetes mellitus more frequently and also had urgent surgery compared to those without infectious complications. In addition, patients with postoperative infectious complications had a significantly more unfavorable outcome compared with those without postoperative infection in cancer-specific, but not overall survival. Multivariate analysis demonstrated that age, rectal cancer and tumor stage correlated with overall survival, but not postoperative infectious complications. However, postoperative infections, as well as gender, were associated with the length of time until the patient succumbed from the recurrence of colorectal cancer after resection for curative intent. thus, postoperative infectious complications are predictors of adverse clinical outcome in patients with colorectal cancer. However, further immunological study is necessary to confirm the biological significance of these findings.

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“…Two reports on the impact of postoperative fever on survival in patients with colorectal cancer yielded contradictory results. 6,7 In one retrospective study of 227 patients who underwent curative surgery, Nowacki and Szymendera 6 found that postoperative fever, was the most unfavorable prognostic factor, followed by disease stage. However, the results of that study could not be replicated in a later study of 111 colorectal cancer patients, 7 and the question remained unanswered for the following two decades.…”

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confidence: 99%