Annals of Surgical Oncology

, Volume 24, Issue 4, pp 1135–1142 | Cite as

Long-Term Impact of Postoperative Complications on Cancer Recurrence Following Lung Cancer Surgery

  • Takashi Nojiri
  • Toshimitsu Hamasaki
  • Masayoshi Inoue
  • Yasushi Shintani
  • Yukiyasu Takeuchi
  • Hajime Maeda
  • Meinoshin Okumura
Thoracic Oncology

Abstract

Background

Postoperative complications are associated with poor cancer-specific survival in various types of cancer surgery. Recent studies suggest that systemic inflammation induced by surgical trauma can accelerate the adhesion of circulating tumor cells to the vascular endothelium of distant organs, resulting in early cancer recurrence. We investigated the impact of postoperative cardiopulmonary complications on cancer recurrence following lung cancer surgery.

Methods

From a prospective database of 675 consecutive patients who underwent curative surgery for lung cancer between 2007 and 2012, the incidence of postoperative cardiopulmonary complications, white blood cell counts, and C-reactive protein levels were evaluated in the acute phase after surgery. Four patients had both cardiovascular and respiratory complications. The remaining 671 patients were divided into 3 groups: patients without cardiopulmonary complications; those with cardiovascular complications; and those with respiratory complications. The incidence of cancer recurrence was compared among the three groups.

Results

Postoperative cardiovascular or respiratory complications were identified in 94 (14%) or 25 (4%) patients, respectively. Postoperative white blood cell counts and C-reactive protein levels were significantly higher in those with postoperative respiratory complications than in those without. There was a significantly higher incidence of cancer recurrence in those with postoperative respiratory complications than in those without (48.0 vs. 16.8%; p < 0.0001). Multiple regression analysis adjusted for age, sex, and pathological staging showed that the incidence of postoperative respiratory complications was a significant predictor of cancer recurrence.

Conclusions

The presence of respiratory complications following lung cancer surgery was a significant predictor of cancer recurrence.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Takashi Nojiri
    • 1
    • 2
    • 3
  • Toshimitsu Hamasaki
    • 4
  • Masayoshi Inoue
    • 1
  • Yasushi Shintani
    • 1
  • Yukiyasu Takeuchi
    • 3
  • Hajime Maeda
    • 3
  • Meinoshin Okumura
    • 1
  1. 1.Department of General Thoracic SurgeryOsaka University Graduate School of MedicineSuitaJapan
  2. 2.Department of BiochemistryNational Cerebral and Cardiovascular Center Research InstituteSuitaJapan
  3. 3.Department of General Thoracic SurgeryNational Hospital Organization Toneyama HospitalToyonakaJapan
  4. 4.Department of Clinical Research and DevelopmentNational Cerebral and Cardiovascular CenterSuitaJapan

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