Treatment Outcomes of Patients Treated for Pulmonary Tuberculosis after Undergoing Gastrectomy

Abstract

Gastrectomy is a proxy of malnutrition, which may lead to increased risk for developing pulmonary tuberculosis (TB). Malabsorption in gastrectomy patients could lead to low serum levels of rifampicin, which may be related to higher treatment failure. However, there is limited information on treatment outcomes of TB in patients who have undergone gastrectomy. This study aims to determine treatment outcomes and adverse effects in patients treated for TB after undergoing gastrectomy for gastric cancer. During the study period, 112 patients were treated for active TB that developed after gastrectomy for gastric cancer. Among them, we selected 15 patients who were culture positive at initial diagnosis and had evidence of active TB on imaging studies; namely, the remaining 97 patients without initial culture or imaging studies were excluded. We thus performed a case-control study of gastric cancer patients treated for TB after undergoing gastrectomy (n = 15). The control group was defined as age-and sex-matched TB patients who had not received gastrectomy (n = 45). Treatment failure in clinical, microbiological aspects, and adverse events were analyzed. Patients who had undergone gastrectomy exhibited higher 4-month clinical failure rates, compared to non-gastrectomy patient: 4 (26.7%) vs. 1 (2.2%), P = 0.012. Gastrointestinal adverse effects were more frequent in patients with gastrectomy, compared to non-gastrectomy patients: 9 (60%) vs. 5 (11.1%), P < 0.001. In conclusion, patients treated for TB after undergoing gastrectomy are associated with higher rates of gastrointestinal adverse events and treatment failure.

Incidence of and Risk Factors for Tuberculosis among Cancer Patients in Endemic Area: A Regional Cohort Study

“…It was consistent with Kim et al, which found that immune suppression by the tumor increased vulnerability to reactivation of TB (Kim et al, 2008). Several studies from Taiwan and Korea have also identified gastric cancer as a significant risk factor for TB (Fang et al, 2015;Jung et al, 2016). The digestive organ in this study included esophagus, stomach, small intestine and other ill-defined digestive organs.…”

Active Tuberculosis Risk Associated with Malignancies: A 4-Year Retrospective Study in a Tertiary Care Hospital

“…10,20 Numerous studies from Taiwan and Korea have also identified gastric cancer as an important risk factor for TB. 20,32,33 Since the digestive organs are important for nutrition, digestive organ dysfunction can lead to malnutrition and opportunistic infections. 20 Macrophages are a major component of TILs in gastrointestinal cancers.…”