Postoperative Pneumonia is Associated with Long-Term Oncologic Outcomes of Definitive Chemoradiotherapy Followed by Salvage Esophagectomy for Esophageal Cancer

Takeuchi, Masashi; Kawakubo, Hirofumi; Mayanagi, Shuhei; Yoshida, Kayo; Fukuda, Kazumasa; Nakamura, Rieko; Suda, Koichi; Wada, Norihito; Takeuchi, Hiroya; Kitagawa, Yuko

doi:10.1007/s11605-018-3857-z

Cited by 30 publications

(30 citation statements)

References 35 publications

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“…13 Several studies identify postoperative pneumonia as a predictor of short-term and long-term mortality after surgery. [14][15][16][17][18][19] Is there a difference in the outcomes of postoperative pneumonia between patients with and without T2DM?…”

Section: Introductionmentioning

confidence: 99%

<p>The Effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery</p>

Liu

et al. 2019

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The aim of the study was to explore the relationship between type 2 diabetes (T2DM) and postoperative pneumonia, and the effects of T2DM and postoperative pneumonia on the mortality in inpatients with surgery. Methods: A retrospective study was conducted on 43,174 inpatients with surgery in The First Hospital of Qinhuangdao. These patients were divided into four groups according to T2DM and postoperative pneumonia, Group A subjects without T2DM and postoperative pneumonia, Group B subjects with T2DM only, Group C subjects with postoperative pneumonia only and Group D subjects with T2DM and postoperative pneumonia. Inhospital mortality was collected. Results: The incidences of postoperative pneumonia were higher in patients with T2DM than patients without T2DM (T2DM 3.2% vs Non-diabetes 1.7%, χ 2 =36.219, P<0.001). The mortalities were 0.3% in Group A, 0.3% in Group B, 4.6% in Group C and 8.6% in Group D. In multiple logistic regression analysis, adjusted for sex, age, emergency admissions, coronary heart disease, heart failure, chronic kidney disease, hypoproteinemia, stroke and transient ischemic attack, the mortalities of Group C and Group D were 4.515 (95% CI: 2.779～7.336, P<0.001) times and 8.468 (95% CI: 3.567～20.099, P<0.001) times than the mortality of Group A. Conclusion: T2DM is susceptible to postoperative pneumonia. The mortality increased in patients with postoperative pneumonia. When patients with T2DM and postoperative pneumonia at the same time, the mortality increased further. In T2DM patients with postoperative pneumonia, perioperative management should be improved for patient safety.

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Section: Introductionmentioning

confidence: 99%

<p>The Effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery</p>

Liu

et al. 2019

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“…Their results indicate that complications might lead to death from other diseases in the long term. Takeuchi et al [21] investigated the prognosis of 49 patients who underwent salvage esophagectomy. They reported that 9 (56%) of 16 patients with postoperative pneumonia after salvage esophagectomy died from illnesses unrelated to esophageal cancer over the long term.…”

Section: Discussionmentioning

confidence: 99%

“…These two results are consistent with our result that deaths from other diseases were more [20] stated that low albumin level, high C-reactive protein level, clinical node positivity, and operative blood loss are associated with the occurrence of postoperative complications. Hayami et al [21] reported that low BMI, poor performance status, and high radiation dose are associated with Overall survival (OS) curves by postoperative complication status, pulmonary complication status, and anastomotic leakage status. a Survival of patients with complications was significantly poorer than survival of patients without complications (HR, 2.06; p = 0.017).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Postoperative Complications following Salvage Esophagectomy for Esophageal Cancer after Definitive Chemoradiotherapy

et al. 2020

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Background: Recent studies have reported that the occurrence of postoperative complications after esophagectomy for esophageal cancer has a negative impact on long-term survival. Although salvage esophagectomy is associated with higher rates of morbidity and mortality, the impact of postoperative complications on long-term survival following salvage esophagectomy has not been fully investigated. Methods: We retrospectively analyzed 73 patients with thoracic esophageal cancer who underwent salvage esophagectomy between January 1997 and December 2017 after definitive chemoradiotherapy. We investigated the clinical impact of postoperative complications on long-term survival after salvage esophagectomy. Results: Postoperative complications, pulmonary complications, and anastomotic leakage occurred in 34 (47%), 14 (13%), and 14 (19%) of the patients, respectively. Patients with complications had significantly poorer survival than patients who did not have complications (HR [hazard ratio], 2.06; p = 0.017), but there were no significant differences in overall survival between patients with and those without pulmonary complications or anastomotic leakage (HR, 1.48, p = 0.318, and HR, 1.37, p = 0.377, respectively). Multivariate analysis revealed that pathological T3-4 disease (HR, 4.63; p = 0.001), residual disease (HR, 5.09; p = 0.001), and postoperative complications (HR, 3.85; p = 0.001) were significant independent prognostic factors. In particular, the frequency of death from other diseases among patients with postoperative complications was nonsignificantly higher than among patients without postoperative complications (26 vs. 10%; p = 0.071). Conclusion: The occurrence of complications leads to a poor prognosis for patients with esophageal cancer after salvage esophagectomy. Prevention of postoperative complications and long-term postoperative general supportive care might be important for improving patients' prognosis.

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“…47 R0 resection was performed in 42.4%-86.9% of cases. [18][19][20][21][22][23][24][25][26][27][28][29][33][34][35][36][37][38][39][40][41]44,46 One-year, 3-year, and 5-year OS rates were 45.7%-84%, 18,27,34,[36][37][38]40,46 29.8%-63%, 18,[26][27][28]34,38,40,46 and 5.7%-51.6%, 18,26,27,[34][35][36][37]46 respectively. Multivariate analysis revealed the following independent prognostic factors: R0 resection, 21,[23][24]…”

Section: Ta B L E 1 Summary Of Studies On Esophagectomy After Dcrtmentioning

confidence: 99%

Salvage treatment after definitive chemoradiotherapy for esophageal squamous cell carcinoma

Yagi

Toriumi

Aikou

et al. 2021

Annals of Gastroent Surgery

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Postoperative Pneumonia is Associated with Long-Term Oncologic Outcomes of Definitive Chemoradiotherapy Followed by Salvage Esophagectomy for Esophageal Cancer

Abstract: The present study demonstrates the long-term outcomes and risk factors for mortality of salvage esophagectomy. To improve OS after salvage surgery, the development of a means of decreasing pulmonary complications is needed.

Cited by 30 publications

References 35 publications

<p>The Effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery</p>

<p>The Effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery</p>

Prognostic Impact of Postoperative Complications following Salvage Esophagectomy for Esophageal Cancer after Definitive Chemoradiotherapy

Salvage treatment after definitive chemoradiotherapy for esophageal squamous cell carcinoma

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