Poor prognosis in esophageal cancer patients with postoperative complications

Hirai, Toshihiro; Yamashita, Yoshihisa; Mukaida, Hidenori; Kuwahara, Masaki; Inoue, Hideki; Toge, Tetsuya

doi:10.1007/s005950050187

Cited by 88 publications

(73 citation statements)

References 19 publications

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“…Major perioperative morbidities may not have a significant effect on long-term survival due to the high-volume of esophagectomys performed at our institution ( Figure 2 However, it has been reported that postoperative infections do have a negative impact on longterm survival in major gastro-intestinal cancer resections 16,17 . In a study conducted by Lerut and colleagues on the impact of postoperative complications after transthoracic esophagectomy using the modified Clavien classification, similar results were reported that there was no difference in survival curves between grades 2, 3, and 4 complications 5 .…”

Section: Discussionmentioning

confidence: 94%

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

et al. 2012

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Introduction The incidence of cancer of the esophagus/GE junction is dramatically increasing but continues to have a dismal prognosis. Esophagectomy provides the best opportunity for long‐term cure but is hampered by increased rates of perioperative morbidity. We reviewed our large institutional experience to evaluate the impact of postoperative complications on the long‐term survival of patients undergoing resection for curative intent. Methods We identified 237 patients who underwent esophagogastrectomy, with curative intent, for cancer between 1994 and 2008. Complications were graded using the previously published Clavien scale. Survival was calculated using Kaplan–Meier methodology and survival curves were compared using log‐rank tests. Multivariate analysis was performed with continuous and categorical variables as predictors of survival, and examined with logistic regression and odds ratio confidence intervals. Results There were 12 (5 %) perioperative deaths. The average age of all patients was 62 years, and the majority (82 %) was male. Complication grade did not significantly affect long‐term survival, although patients with grade IV (serious) complications did have a decreased survival (p = 0.15). Predictors of survival showed that the minimally invasive type esophagectomy (p = 0.0004) and pathologic stage (p = 0.0007) were determining factors. There was a significant difference in overall survival among patients who experienced pneumonia (p = 0.00016) and respiratory complications (p = 0.0004), but this was not significant on multivariate analysis. Conclusions In this single‐institution series, we found that major perioperative morbidity did not have a negative impact on long‐term survival which is different than previous series. The impact of tumor characteristics at time of resection on long‐term survival is of most importance.

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Section: Discussionmentioning

confidence: 94%

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

et al. 2012

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“…Many researchers have reported that postoperative surgical and medical complications may contribute to a high rate of recurrence and unfavorable long-term survival in various malignancies such as cervical, colorectal and esophageal cancer (3)(4)(5). Increasing evidence has shown that postoperative complications due to infection, especially those caused by anastomotic leakage after colorectal surgery, were significantly associated with a negative long-term outcome (3,(6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Postoperative infections are associated with adverse outcome after resection with curative intent for colorectal cancer

Tsujimoto¹,

Ueno²,

Hashiguchi³

et al. 2010

Oncology Letters

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Abstract. this study focused on the impact of post-operative infection on patient outcome after resection with curative intent for colorectal cancer. Postoperative surgical and medical complications have been implicated as a negative predictor of long-term outcome in various malignancies. We studied a population of 1083 patients who underwent resection with curative intent for colorectal cancer. these patients were divided into 2 groups based on the occurrence (65 patients, 6%) or absence (1018 patients, 94%) of postoperative complications due to infection. We investigated the demographic and clinicopathological features of each patient with and without postoperative infectious complications, as well as the impact of postoperative infection on long-term survival. results showed that patients with postoperative infectious complications had diabetes mellitus more frequently and also had urgent surgery compared to those without infectious complications. In addition, patients with postoperative infectious complications had a significantly more unfavorable outcome compared with those without postoperative infection in cancer-specific, but not overall survival. Multivariate analysis demonstrated that age, rectal cancer and tumor stage correlated with overall survival, but not postoperative infectious complications. However, postoperative infections, as well as gender, were associated with the length of time until the patient succumbed from the recurrence of colorectal cancer after resection for curative intent. thus, postoperative infectious complications are predictors of adverse clinical outcome in patients with colorectal cancer. However, further immunological study is necessary to confirm the biological significance of these findings.

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“…Second, we did not analyze the effect of other perioperative comorbidities related to blood transfusions, such as postoperative infection, which had been suggested as playing a role in the postoperative rate of cancer recurrence. 42 Furthermore, we did not analyze the effect of any blood transfusion vs no blood transfusion on cancer recurrence. In a meta-analysis, Amato and Pescatori 43 showed a detrimental association between the use of blood transfusion and outcome in patients with colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

Cata

Klein

Hoeltge

et al. 2011

Mayo Clinic Proceedings

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Poor prognosis in esophageal cancer patients with postoperative complications

Cited by 88 publications

References 19 publications

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

Major Perioperative Morbidity Does Not Affect Long‐Term Survival in Patients Undergoing Esophagectomy for Cancer of the Esophagus or Gastroesophageal Junction

Postoperative infections are associated with adverse outcome after resection with curative intent for colorectal cancer

Blood Storage Duration and Biochemical Recurrence of Cancer After Radical Prostatectomy

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