Impact of infectious complications on gastric cancer recurrence

Hayashi, Tsutomu; Yoshikawa, Takaki; Aoyama, Toru; Hasegawa, Shin; Yamada, Takanobu; Tsuchida, Kazuhito; Fujikawa, Hirohito; Sato, Tsutomu; Ogata, Takashi; Cho, Haruhiko; Oshima, Takashi; Rino, Yasushi; Masuda, Munetaka

doi:10.1007/s10120-014-0361-3

Cited by 99 publications

(89 citation statements)

References 14 publications

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“…have analyzed the impact of postoperative complications on recurrence and survival after gastric cancer resection. In this study conducted in Spain, the incidence of postoperative complications (Clavien‐Dindo grade II or higher) was reported as 59.8%, which is somewhat higher than that reported elsewhere 36, 37, 38. They have concluded that these complications do not have a negative impact on oncological outcome.…”

Section: Resultsmentioning

confidence: 59%

“…Several studies have reported a negative impact of postoperative complications on patient prognosis after gastric cancer surgery using multivariate analysis 35, 36, 37, 38, 39. Table 2 and Figure 2 show the summarized results of studies evaluating the prognostic impact of postoperative complications.…”

Section: Resultsmentioning

confidence: 99%

“…All eligible studies reported adjusted hazard ratios obtained using multivariate analysis; the overall hazard ratio was 1.59 (95% CI, 1.13–2.24), with a statistically significant heterogeneity ( P < 0.0001). In each study, postoperative complications were defined by a Clavien‐Dindo grade higher than II,34, 35, 36, 37 which was observed in 10.3–14.5% of the studied patients. There were no apparent differences between the incidences of postoperative complications among large‐volume institutions in Japan.…”

Section: Resultsmentioning

confidence: 99%

“…The prognoses of OS,35, 39 relapse‐free survival (RFS),36 both OS and oncological outcome,37 and both OS and RFS38 were evaluated. We found reports on the negative impact of postoperative complications on patient prognosis for every stage of gastric cancer,36 stage III gastric cancer,37 and stages II and III gastric cancers 38. Cancer‐related death is not commonly observed in the early stages of gastric cancer; thus, its negative impact on RFS might be characteristic of stage III gastric cancer patients.…”

Section: Resultsmentioning

confidence: 99%

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Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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Section: Resultsmentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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“…In a previous paper [23], we reported the association between intraabdominal infectious complications after surgery for gastric cancer and survival outcomes. Hayashi et al [24] and Kubota et al [25] also reported that complications following surgery for gastric cancer shorten relapse-free and overall survival rates. In the present study, survival outcomes may have been affected by the increased complications resulting from the concurrent performance of gastrectomy and hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of hepatectomy for liver metastases of gastric cancer diagnosed using contrast-enhanced magnetic resonance imaging

et al. 2016

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Background Chemotherapy is the standard treatment for liver metastases of gastric cancer (LMGC). Hepatectomy for LMGC reportedly has a 5-year survival rate of 13-37 %; however, its significance has not been established. At our hospital, hepatectomy is performed for patients with three or fewer metastases diagnosed using contrast-enhanced magnetic resonance imaging (MRI). To identify the ideal patient subpopulation for resection, we retrospectively analyzed treatment outcomes in patients with LMGC who underwent hepatectomy. Methods Clinicopathological factors affecting survival were explored using univariate and multivariate analyses in 28 patients who underwent hepatectomy for LMGC diagnosed using contrast-enhanced MRI between December 2004 and October 2014. Results The study included 23 men and 5 women with a median age of 72 years. Metastases were synchronous in 15 patients and metachronous in 13 patients. The median overall survival time was 49 months, with a 5-year survival rate of 32 %. Univariate analysis revealed that overall survival time was shorter in the presence of the following factors: age C70 years (p = 0.030), synchronous liver metastases (p = 0.017), and presence of postoperative complications (p = 0.042). In patients with metachronous liver metastases, the post-resection 5-year survival rate was 59 %. Conclusions The 5-year survival rate was 32 % in patients who underwent hepatectomy for LMGC according to our criteria, suggesting that hepatectomy is an important treatment if indications are on the basis of contrast-enhanced MRI. Therefore, active resection should be considered, particularly for patients with metachronous liver metastases.

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Long‐term impact of postoperative pneumonia after curative gastrectomy for elderly gastric cancer patients

Suzuki

Kanaji

Matsuda

et al. 2017

Annals of Gastroent Surgery

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With the extension of life expectancy, cancer has been increasing in elderly populations. Postoperative pneumonia can negatively influence immediate mortality following gastrectomy for elderly patients, but its impact on long‐term survival remains unclear. We retrospectively reviewed the cases of patients aged ≥75 years who underwent curative gastrectomy for gastric cancer from 2000 to 2014 to determine the long‐term effects of postoperative pneumonia and to identify independent risk factors along with physical status and surgical procedure. Of 250 patients, 32 (12.8%) developed postoperative pneumonia. Patients with postoperative pneumonia had significantly worse overall survival (OS) than those without postoperative pneumonia (P<.001). A multivariate analysis identified postoperative pneumonia as a prognostic factor for OS (hazard ratio, 2.06; 95% CI, 1.05‐3.75; P=.036). Significant risk factors for the development of postoperative pneumonia were male gender (P=.026) and D2 lymphadenectomy (P<.001). D2 lymphadenectomy was associated with poorer OS than D1 or D1+lymphadenectomy in patients with an American Society of Anesthesiologists (ASA) score 3 (P=.026), but did not influence OS negatively in patients with an ASA score ≤2. Limited lymphadenectomy did not affect the cancer‐specific survival of elderly patients with ASA score 3. Postoperative pneumonia following gastrectomy has an adverse impact on the long‐term survival of elderly gastric cancer patients. A limited lymphadenectomy during curative resection should be considered to prevent postoperative pneumonia in frail elderly patients with ASA score 3. Postoperative pneumonia following gastrectomy has an adverse impact on the long‐term survival of elderly gastric cancer patients. Extent of lymph node dissection during curative resection should be limited to prevent postoperative pneumonia, based on the patient's frailty.

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Impact of infectious complications on gastric cancer recurrence

Cited by 99 publications

References 14 publications

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Treatment outcomes of hepatectomy for liver metastases of gastric cancer diagnosed using contrast-enhanced magnetic resonance imaging

Long‐term impact of postoperative pneumonia after curative gastrectomy for elderly gastric cancer patients

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