Postoperative complications do not impact on recurrence and survival after curative resection of gastric cancer

Abstract

BackgroundWe assessed the impact of complications on recurrence and survival after curative gastric cancer resection. MethodsPatients undergoing R0 resections between 1990 and 2009 were identified in a prospectively maintained database and were categorized by presence of any complication Clavien-Dindo (CD) ≥ II, sepsis or intra-abdominal sepsis. Cox regression analyses to relate complications and clinico-pathological variables to time to recurrence (TTR) and overall survival (OS) were performed. ResultsA total of 271 patients were included with a median follow-up of 149.9 months (range 140.1–159.9). Complications CD ≥ II occurred in 162 (59.8%) patients, sepsis in 66 (22.5%), and intra-abdominal sepsis in 37 (13.6%). Recurrence developed in 88 (32.4%) patients. Independent predictors of short TTR were pTNM stage (IIIB-IIIC vs. IA-IIA) (hazard ratio [HR] = 37.55, 95% confidence interval [CI] 17.57–80.24; p < 0.001), D1 lymphadenectomy (HR = 3.14, 95% CI 1.94–5.07; p < 0.001), and male gender (HR = 1.65, 95% CI 1.06–2.57; p = 0.026). pTNM stage (IIIB–IIIC vs. IA–IIA, HR = 10.28, 95% CI 6.51–16.23; p < 0.001), male gender (HR = 1.64, 95% CI 1.17–2.31; p = 0.005), age (HR = 1.03, 95% CI 1.02–1.05; p < 0.001), and adjuvant therapy (HR = 0.55, 95% CI 0.37–0.83; p = 0.004) were identified as independent predictors of OS.. ConclusionsEvidence provided by this study does not support a negative impact of postoperative complications CD ≥ II, sepsis, and intra-abdominal sepsis on the oncologic outcome after curative gastric cancer resection.