Impact of Postoperative Infection on Long-Term Survival After Potentially Curative Resection for Gastric Cancer
Impact of Postoperative Infection on Long-Term Survival After Potentially Curative Resection for Gastric Cancer
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DOI：
10.1245/s10434-008-0249-8
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发表时间：
2009-02-01
影响因子：
3.7
通讯作者：
Hase, Kazuo
中科院分区：
文献类型：
--
作者：
Tsujimoto, Hironori;Ichikura, Takashi;Hase, Kazuo
我们关注的是术后感染对胃癌切除后长期生存的影响。术后手术和医疗并发症已被认为是各种恶性肿瘤长期预后的负面预测因素。然而，尚未有报道评估胃癌术后感染并发症对生存的影响。我们研究了1332例接受根治性胃癌切除术的患者。根据感染术后并发症的发生（141例，10.6%）和未发生（1191例，89.4%）分为两组。我们调查了每位有和没有术后感染并发症的患者的人口学和临床病理特征，从而研究了术后感染对长期生存的影响。术后感染患者男性发生率、肿瘤位置、全胃切除术发生率、胃癌分期、年龄均明显高于未发生术后感染的患者。术后感染并发症患者的不良预后明显高于无术后感染的患者。多变量分析表明，年龄、术前合并症、输血、肿瘤深度、淋巴结累及和术后感染与总生存率相关。我们得出结论，感染术后并发症是胃癌患者不良临床结局的预测因子。然而，需要进一步的免疫学研究和前瞻性试验来证实这些发现的生物学意义。
We focused on the impact of postoperative infection on long-term survival after potentially curative resection for gastric cancer. Postoperative surgical and medical complications have been implicated as a negative predictor of long-term outcome in various malignancies. However, there have been no published reports assessing the impact of complications arising from postoperative infection on survival in gastric cancer. We studied a population of 1,332 patients who underwent curative resection for gastric cancer. These patients were divided into two groups based on the occurrence (141 patients, 10.6%) or absence (1,191 patients, 89.4%) of postoperative complications due to infection. We investigated the demographic and clinicopathological features of each patient with and without postoperative complications from infection, and thereby the impact of postoperative infection on long-term survival. Patients with postoperative infection had significantly higher frequency of males, upper side tumor location, and total gastrectomy as a surgical procedure, more advanced stage of gastric cancer, and greater age compared with those without postoperative infection. Patients with complications due to postoperative infection had significantly more unfavorable outcome compared with those patients without postoperative infection. Multivariate analysis demonstrated that age, preoperative comorbidity, blood transfusion, tumor depth, nodal involvement, and postoperative infection correlated with overall survival. We conclude that postoperative complications from infection are a predictor of adverse clinical outcome in patients with gastric cancer. However, further immunological study and prospective trials are necessary to confirm the biological significance of these findings.