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Effect of High Postoperative Body Temperature on Long-Term Prognosis in Patients with Gastric Cancer After Radical Resection

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Abstract

Background

There is a lack of data on the effect of high postoperative body temperature on disease-free survival (DFS) in patients who underwent radical gastrectomy.

Methods

Patients who underwent radical gastrectomy from January 2006 to December 2011 were selected. The highest body temperature within 1 week after operation was used to establish diagnostic thresholds for high and low body temperature through X-tile software.

Results

A total of 1396 patients were included in the analysis. The diagnostic threshold for high body temperature was defined as 38 °C; 370 patients were allocated to the high-temperature group (HTG), while another 1026 patients were allocated to the low-temperature group (LTG). For all patients, survival analysis showed that 5-year DFS in the HTG was significantly lower than that for the LTG (55.6% vs 63.9%, P = 0.007). Multivariate analysis revealed that high postoperative body temperature was an independent prognostic risk factor for 5-year DFS (HR = 1.288 (1.067–1.555), P = 0.008). For patients without complications, survival analysis showed that the 5-year DFS rate in the HTG was lower than that for the LTG (57.5% vs 64.4%, P = 0.051), especially in patients with stage III gastric cancer (31.3% vs 41.7%, P = 0.037). For patients with complications or infectious complications, there were no significant differences between the HTG and LTG regarding 5-year DFS (49.3% vs 58.2%, P = 0.23 and 49.4% vs 55.1%, P = 0.481, respectively).

Conclusion

For stage III gastric cancer patients without complications, high postoperative body temperature can significantly reduce the 5-year DFS. These patients may benefit from more aggressive adjuvant therapy and postoperative surveillance regimens.

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Acknowledgements

We are thankful to Fujian Medical University Union Hospital for their management of our gastric cancer patient database.

Funding

The study was sponsored by the Scientific and technological innovation joint capital projects of Fujian Province (2016Y9031); Construction Project of Fujian Province Minimally Invasive Medical Center (No. [2017]171); the second batch of special support funds for Fujian Province Innovation and Entrepreneurship Talents (2016B013); Youth Scientific Research Subject of Fujian Provincial Health and Family Planning Commission (No. 2015-1-37); QIHANG funds of Fujian Medical University (No. 2016QH025); and Chinese physicians association young physician respiratory research fund of Fujian Province Medical Innovation Project (2015-CXB-16).

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Author notes

  1. Hua-Long Zheng and Jun Lu have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China

    Hua-Long Zheng, Jun Lu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Chao-Hui Zheng & Chang-Ming Huang

  2. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China

    Hua-Long Zheng, Jun Lu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Chao-Hui Zheng & Chang-Ming Huang

  3. Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, Fujian Province, China

    Hua-Long Zheng, Jun Lu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Chao-Hui Zheng & Chang-Ming Huang

  4. Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, Fujian Province, China

    Hua-Long Zheng, Jun Lu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Mi Lin, Ru-Hong Tu, Ze-Ning Huang, Ju-Li Lin, Chao-Hui Zheng & Chang-Ming Huang

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  1. Hua-Long Zheng
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Correspondence to Ping Li, Chao-Hui Zheng or Chang-Ming Huang.

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268_2019_4965_MOESM1_ESM.tif

Supplementary Figure 1 5-year overall survival and disease-specific survival for stage III patients with no complication. (TIFF 585 kb)

Supplementary Figure 2 5-year disease-free survival: LTG VS HTG in patients with complications. (TIFF 787 kb)

268_2019_4965_MOESM3_ESM.tif

Supplementary Figure 3 5-year disease-free survival: LTG VS HTG in patients with infectious complications. (TIFF 779 kb)

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Supplementary material 6 (DOCX 59 kb)

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Zheng, HL., Lu, J., Li, P. et al. Effect of High Postoperative Body Temperature on Long-Term Prognosis in Patients with Gastric Cancer After Radical Resection. World J Surg 43, 1756–1765 (2019). https://doi.org/10.1007/s00268-019-04965-5

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