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

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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.

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Author notes

    Authors and Affiliations

    1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

      Jun Kiuchi, Shuhei Komatsu, Daisuke Ichikawa, Toshiyuki Kosuga, Kazuma Okamoto, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara & Eigo Otsuji

    2. Division of Dysphagia Nursing, Department of Nursing, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto, Japan

      Tomoyo Yasuda

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    1. Jun Kiuchi
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    2. Shuhei Komatsu
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    3. Daisuke Ichikawa
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    4. Toshiyuki Kosuga
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    5. Kazuma Okamoto
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    8. Hitoshi Fujiwara
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    9. Tomoyo Yasuda
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    10. Eigo Otsuji
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    Correspondence to Shuhei Komatsu.

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    All authors have no conflict of interests to disclose.

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    J. Kiuchi and S. Komatsu equally contributed to this work.

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    Kiuchi, J., Komatsu, S., Ichikawa, D. et al. Putative risk factors for postoperative pneumonia which affects poor prognosis in patients with gastric cancer. Int J Clin Oncol 21, 920–926 (2016). https://doi.org/10.1007/s10147-016-0987-8

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    • DOI: https://doi.org/10.1007/s10147-016-0987-8

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