Major postoperative complications are associated with impaired long-term survival after gastro-esophageal and pancreatic cancer surgery: a complete national cohort study

Aahlin, Eirik Kjus; Olsen, Frank; Uleberg, Bård; Jacobsen, Bjarne K.; Lassen, Kristoffer

doi:10.1186/s12893-016-0149-y

Cited by 44 publications

(30 citation statements)

References 18 publications

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“…Similarly, surgical stress can lead to the onset of prothrombotic and immunosuppressive changes during the postoperative period 2,3 . Many correlative studies have confirmed an association between postoeprative complications, immune suppression and worsened cancer survival [4][5][6][7] . Our group and others have proposed surgery-induced cellular immune suppression as a primary factor in the progression of cancer, including local recurrence and metastases [8][9][10][11][12][13][14][15][16][17][18][19][20] .…”

Section: Introductionmentioning

confidence: 96%

Sepsis Increases Perioperative Metastases in a Murine Model

Tai

Ananth

Seth

et al. 2017

Preprint

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Section: Introductionmentioning

confidence: 96%

Sepsis Increases Perioperative Metastases in a Murine Model

Tai

Ananth

Seth

et al. 2017

Preprint

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“…Postoperative complications impact patients' oncologic outcomes and have been associated with impaired survival in esophageal and gastric cancer . This might be related to postoperative weight loss and worsened nutritional status, which could, along with previous comorbidities, lead to performance status decline and worse overall survival.…”

Section: Introductionmentioning

confidence: 99%

Predicting overall and major postoperative morbidity in gastric cancer patients

Coimbra

Jesus

Franco

et al. 2019

Journal of Surgical Oncology

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Background Postoperative complications after gastric cancer resection vary in different series and they might have a significant impact in long‐term outcomes. Our aim was to build a prediction rule on gastric cancer patients' overall and major morbidity risks. Methods This retrospective study included 1223 patients from a single center who were resected between 1992 and 2016. Overall and major morbidity predictors were identified through multiple logistic regression. Models' performances were assessed through discrimination, calibration, and cross‐validation, and nomograms were constructed. Results The mean age was 61.3‐year old and the male gender was more frequent (60%). The most common comorbidities were hypertension (HTN), diabetes, and chronic obstructive pulmonary disease (COPD). A D2‐distal gastrectomy was the most frequent procedure and 87% of all lesions were located in the middle or distal third. Age, COPD, coronary heart disease, chronic liver disease, pancreatic resection, and operative time were independent predictors of overall and major morbidity. The extent of resection and splenectomy was associated with overall events and HTN with major ones. Both models were very effective in predicting events among patients at higher risk. Conclusions The overall and major morbidity models and nomograms included clinical‐ and surgical‐related data that were very effective in predicting events, especially for high‐risk patients.

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“…Various reports have shown that such postoperative complications frequently reduce the overall survival (OS) as well as cancer‐specific survival after major surgery for cancer 9. In particular, severe postoperative complications are associated with impaired long‐term survival after gastroesophageal and pancreatic cancer surgery 10. One possible explanation for this phenomenon is that the changes in patient immunological responses trigger the progression of residual disease into a clinically manifest recurrence 11.…”

Section: Introductionmentioning

confidence: 99%

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

104

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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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Major postoperative complications are associated with impaired long-term survival after gastro-esophageal and pancreatic cancer surgery: a complete national cohort study

Cited by 44 publications

References 18 publications

Sepsis Increases Perioperative Metastases in a Murine Model

Sepsis Increases Perioperative Metastases in a Murine Model

Predicting overall and major postoperative morbidity in gastric cancer patients

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

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