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

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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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Disclosure

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan

    Takashi Nojiri MD, PhD, Masayoshi Inoue MD, PhD, Yasushi Shintani MD, PhD & Meinoshin Okumura MD, PhD

  2. Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan

    Takashi Nojiri MD, PhD

  3. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan

    Takashi Nojiri MD, PhD, Yukiyasu Takeuchi MD, PhD & Hajime Maeda MD, PhD

  4. Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Toshimitsu Hamasaki PhD

Authors
  1. Takashi Nojiri MD, PhD
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  2. Toshimitsu Hamasaki PhD
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  3. Masayoshi Inoue MD, PhD
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  4. Yasushi Shintani MD, PhD
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  5. Yukiyasu Takeuchi MD, PhD
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  6. Hajime Maeda MD, PhD
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  7. Meinoshin Okumura MD, PhD
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Corresponding author

Correspondence to Takashi Nojiri MD, PhD.

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Nojiri, T., Hamasaki, T., Inoue, M. et al. Long-Term Impact of Postoperative Complications on Cancer Recurrence Following Lung Cancer Surgery. Ann Surg Oncol 24, 1135–1142 (2017). https://doi.org/10.1245/s10434-016-5655-8

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  • DOI: https://doi.org/10.1245/s10434-016-5655-8

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