Sepsis Increases Perioperative Metastases in a Murine Model

Tai, Lee-Hwa; Ananth, Abhirami A.; Seth, Rashmi; Alkayyal, Almohanad A.; Zhang, Jiqing; Souza, Christiano Tanese de; Staibano, Phillip; Kennedy, Michael A.; Auer, Rebecca C.

doi:10.1101/142083

Cited by 1 publication

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“…It is therefore conceivable that the immunological changes that occur in SIRs, such as those observed after reoperation and under septic conditions, might affect the spread of circulating tumour cells and/or development of adhesions and the formation of metastasis , thereby increasing the risk of recurrence. These findings have been demonstrated in vitro , but the results of the present study did not support this theory.…”

Section: Discussioncontrasting

confidence: 99%

Postoperative complications following colonic resection for cancer are associated with impaired long‐term survival

2019

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Aim Surgery for colorectal cancer is associated with a high incidence of postoperative complications. The aim of this study was to analyse whether postoperative complications following radical resection for colorectal cancer are associated with increased recurrence rate and impaired survival.Method Patients operated for colon cancer between 2007 and 2009 with curative intent were identified through the Swedish Colorectal Cancer Registry. The cohort was divided into three subgroups: patients who developed severe postoperative complications, patients who developed non-severe complications and patients who did not develop any complication (controls). ResultsOf 6779 patients included in the study, 640 (9%) developed severe complications, 994 (15%) nonsevere complications and 5145 (76%) had no complications. The 5-year overall survival rate was 60.3% in the severe complication group, 64.2% in the non-severe complication group and 72.8% in the control group (P < 0.01). The 3-year disease-free survival rate was 66.8%, 70.9% and 77.8% respectively (P < 0.01). The recurrence rate did not differ between the three groups. In multivariate analysis, both severe and nonsevere complications were found to be risk factors for decreased overall survival at 5 years [hazard ratio (HR) 1.38, 95% CI 1.47-1.92, and HR 1.18, 95% CI 1.27-1.60 respectively; P < 0.05) as well as for decreased 3year disease-free survival (HR 1.37, 95% CI 1.14-1.65, and HR 1.26, 95% CI 1.08-1.48 respectively; P < 0.05).Conclusion Complications after colonic resection for cancer are associated with impaired 5-year overall survival and 3-year disease-free survival and exhibit more severe postoperative complications, mainly via mechanisms other than cancer recurrence.What does this paper add to the literature? The impact on survival and oncological outcome of complications after resection of colon cancer is ambiguous. Our results suggest that complications are associated with impaired long-term survival.

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Section: Discussioncontrasting

confidence: 99%