nach oben

International Journal of Clinical Oncology

Erschienen in:

12.05.2016 | Original Article

Putative risk factors for postoperative pneumonia which affects poor prognosis in patients with gastric cancer

verfasst von: Jun Kiuchi, Shuhei Komatsu, Daisuke Ichikawa, Toshiyuki Kosuga, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Tomoyo Yasuda, Eigo Otsuji

Erschienen in: International Journal of Clinical Oncology | Ausgabe 5/2016

Einloggen, um Zugang zu erhalten

Abstract

Background and objectives

Several recent studies identified that postoperative infectious complications contribute to recurrence and poor outcome in patients with gastric cancer. This study was designed to investigate the prognostic impact of postoperative pneumonia, and to identify the putative risk factors for its occurrence.

Methods

We retrospectively analyzed 1,415 consecutive patients who underwent curative gastrectomy for gastric cancer between 1997 and 2013.

Results

A total of 31 (2.2 %) patients developed postoperative pneumonia (Clavien–Dindo classification ≥II). Patients with postoperative pneumonia showed a significantly poorer prognosis than patients without (P < 0.001). Concerning the occurrence of postoperative pneumonia, univariate and multivariate analyses identified older age (≥65 years; P = 0.010; odds ratio [OR] 3.59), lower nutritious status (albumin <3 0; P = 0.029; OR 4.51), advanced stage (pStage ≥II; P = 0.045; OR 2.35), concurrent hypertension (P = 0.042; OR 2.21) and total gastrectomy (P = 0.026; OR 2.42) as independent risk factors.

Conclusions

Postoperative pneumonia was shown to be associated with long-term poor outcome in patients with gastric cancer. Care should be taken for patients with clinical factors such as older age, lower nutritional status, advanced stage, concurrent hypertension, and total gastrectomy.

Ferlay J, Shin HR, Bray F et al (2008) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127:2893–2917CrossRef

The Foundation for Promotion of Cancer Research (FPCR) (2013) Cancer statistics in Japan

Zhang Q, Wang F, Chen ZY et al (2015) Comparison of the diagnostic efficacy of white light endoscopy and magnifying endoscopy with narrow band imaging for early gastric cancer: a meta-analysis. Gastric Cancer 19(2):543–552CrossRefPubMed

Kitano S, Shiraishi N, Uyama I, Japanese Laparoscopic Surgery Study Group et al (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg 245(1):68–72CrossRefPubMedPubMedCentral

Komatsu S, Ichikawa D, Kashimoto K et al (2013) Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer. World J Gastroenterol 19(46):8696–8702CrossRefPubMedPubMedCentral

Bang YJ, Van Cutsem E, Feyereislova A et al (2010) Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial. Lancet 376(9742):687–697CrossRefPubMed

Lawrence VA, Hilsenbeck SG, Mulrow CD et al (1995) Incidence and hospital stay for cardiac and pulmonary complications after abdominal surgery. J Gen Intern Med 10:671–678CrossRefPubMed

Thompson DA, Makary MA, Dorman T et al (2006) Clinical and economic outcomes of hospital acquired pneumonia in intra-abdominal surgery patients. Ann Surg 243(4):547–552CrossRefPubMedPubMedCentral

Hayashi T, Yoshikawa T, Aoyama T et al (2015) Impact of infectious complications on gastric cancer recurrence. Gastric Cancer 18(2):368–374CrossRefPubMed

10.

Tokunaga M, Tanizawa Y, Bando E et al (2013) Poor survival rate in patients with postoperative intra-abdominal infectious complications following curative gastrectomy for gastric cancer. Ann Surg Oncol 20(5):1575–1583CrossRefPubMed

11.

Ohtsuka T, Kitajima Y, Takahashi T et al (2009) Infectious complications after gastric cancer surgery accelerate a rapid hepatic recurrence. Hepatogastroenterology 56(94–95):1277–1280PubMed

12.

Fisher BW, Majumdar SR, McAlister FA (2002) Predicting pulmonary complications after nonthoracic surgery: a systematic review of blinded studies. Am J Med 112(3):219–225CrossRefPubMed

13.

McAlister FA, Bertsch K, Man J et al (2005) Incidence of and risk factors for pulmonary complications after nonthoracic surgery. Am J Respir Crit Care Med 171(5):514–517CrossRefPubMed

14.

Inokuchi M, Kojima K, Kato K et al (2014) Risk factors for post-operative pulmonary complications after gastrectomy for gastric cancer. Surg Infect (Larchmt) 15(3):314–321CrossRef

15.

Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 14:101–112CrossRef

16.

Nakajima T (2002) Gastric cancer treatment guidelines in Japan. Gastric Cancer 5:1–5CrossRefPubMed

17.

Kodera Y, Sasako M, Yamamoto S, Gastric Cancer Surgery Study Group of Japan Clinical Oncology Group et al (2005) Identification of risk factors for the development of complications following extended and superextended lymphadenectomies for gastric cancer. Br J Surg 92(9):1103–1109CrossRefPubMed

18.

Cleva R, Assumpção MS, Sasaya F et al (2014) Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery. Clinics (Sao Paulo) 69(7):483–486CrossRef

19.

Pellegrini CA, DeMeester TR, Johnson LF et al (1979) Gastroesophageal reflux and pulmonary aspiration: incidence, functional abnormality, and results of surgical therapy. Surgery 86(1):110–119PubMed

20.

Marumo K, Homma S (2005) Role of gastro-esophageal reflux (GER) and swallowing latency in aspiration pulmonary diseases. Nihon Kokyuki Gakkai Zasshi 43(6):333–339 (in Japanese) PubMed

21.

Marumo K, Homma S, Fukuchi Y (1995) Postgastrectomy aspiration pneumonia. Chest 107(2):453–456CrossRefPubMed

22.

Takeshita H, Ichikawa D, Komatsu S et al (2013) Surgical outcomes of gastrectomy for elderly patients with gastric cancer. World J Surg 37(12):2891–2898CrossRefPubMed

23.

Kawaguchi T, Komatsu S, Ichikawa D et al (2015) Clinical significance of chemotherapy for geriatric patients with advanced or recurrent gastric cancer. Mol Clin Oncol 3(1):83–88PubMed

Titel: Putative risk factors for postoperative pneumonia which affects poor prognosis in patients with gastric cancer
verfasst von: Jun Kiuchi
Shuhei Komatsu
Daisuke Ichikawa
Toshiyuki Kosuga
Kazuma Okamoto
Hirotaka Konishi
Atsushi Shiozaki
Hitoshi Fujiwara
Tomoyo Yasuda
Eigo Otsuji
Publikationsdatum: 12.05.2016
Verlag: Springer Japan
Erschienen in: International Journal of Clinical Oncology / Ausgabe 5/2016
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0987-8

Springer Medizin

Putative risk factors for postoperative pneumonia which affects poor prognosis in patients with gastric cancer