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The prognostic significance of the comprehensive complication index in patients with gastric cancer

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Abstract

Purpose

Postoperative complications worsen the prognosis of gastric cancer patients. The Clavien–Dindo classification is used to evaluate postoperative complications. The prognostic significance of the comprehensive complication index (CCI), a new tool for evaluating postoperative complications, remains unclear.

Methods

This study included 452 gastric adenocarcinoma patients who underwent curative surgery.

Results

The CCI values were significantly higher in older patients ( ≥ 70 years; P < 0.0001), male patients (P < 0.0001), those with lymphatic invasion (P = 0.039), and those with vascular invasion (P = 0.037). The five-year overall survival (OS) and disease-specific survival (DSS) rates were significantly higher in patients without postoperative complications and those with Clavien–Dindo grade 1 complications in comparison to those with Clavien–Dindo grade 2–4 complications (80.4% vs. 66.2%, P = 0.0011; 89.7% vs. 82.3%; P = 0.045, respectively). Among patients with Clavien–Dindo grade 2–4 complications, the 5-year OS and DSS rates in the CCIHigh group ( ≥ 32.15) were significantly lower than those in the CCILow group ( < 32.15; 47.5% vs. 74.9%, P = 0.0086; 63.1% vs. 90.0%, P = 0.0003). A multivariate analysis identified the CCI as an independent prognostic indicator in patients with Clavien–Dindo grade 2–4 complications.

Conclusions

The CCI was closely associated with the prognosis of patients with Clavien–Dindo grade 2–4 complications and may be a prognostic indicator.

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Acknowledgements

We thank Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Funding

The authors received no grants, equipment or funding for this study.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan

    Shota Shimizu, Hiroaki Saito, Yusuke Kono, Yuki Murakami, Yuji Shishido, Kozo Miyatani, Tomoyuki Matsunaga, Yoji Fukumoto & Yoshiyuki Fujiwara

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  1. Shota Shimizu
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  2. Hiroaki Saito
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  3. Yusuke Kono
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  4. Yuki Murakami
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Correspondence to Hiroaki Saito.

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All procedures performed in studies involving human participants were carried out in accordance with the ethical standards of the institutional research committee and the 1964 Helsinki Declaration and its later amendments or with comparable ethical standards.

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Shimizu, S., Saito, H., Kono, Y. et al. The prognostic significance of the comprehensive complication index in patients with gastric cancer. Surg Today 49, 913–920 (2019). https://doi.org/10.1007/s00595-019-01828-3

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  • DOI: https://doi.org/10.1007/s00595-019-01828-3

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