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Postoperative Complications have Minimal Impact on Long-Term Prognosis in Immunodeficient Patients with Esophageal Cancer

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

Abstract

Background

Postoperative complications have been recognized to have an adverse prognostic impact in various types of cancer. However, in a recent study, it has been reported that postoperative complications of total gastrectomy with splenectomy have little impact on the long-term outcomes of patients with gastric cancer. In addition, the mechanisms underlying the effect of postoperative complications on outcomes remain to be elucidated. We hypothesized that immunosuppression by postoperative complications may affect long-term outcomes in patients with esophageal cancer.

Methods

In this retrospective study, we assessed in 153 patients with esophageal cancer who underwent curative subtotal esophagectomy at our hospital and examined the correlation between postoperative complications, and multiple clinicopathological factors, and long-term outcomes with the patients stratified by total lymphocyte count (TLC).

Results

The median preoperative TLC was 1432. A total of 115 patients (75.2%) had a TLC of ≥ 1000/μL (high TLC group), and the remaining 38 patients (24.8%) had a TLC of < 1000/μL (low TLC group). Postoperative complications occurred in 39 of 153 cases (25.5%). There was no significant correlation between postoperative complications and any of the clinicopathological factors in either group. In the high TLC group, patients with postoperative complications had significantly lower overall and disease-free survival rates compared with those without complications (p < 0.001 and p < 0.01, respectively). In the low TLC group, no survival difference between patients with and without postoperative complications was observed.

Conclusions

Postoperative complications may have a minimal impact on long-term outcomes in immunodeficient patients.

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Acknowledgements

The authors are grateful to Makiko Mishina for expert technical assistance.

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Authors and Affiliations

  1. First Department of Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan

    Suguru Maruyama PhD, MD, Yoshihiko Kawaguchi PhD, MD, Hidenori Akaike PhD, MD, Katsutoshi Shoda PhD, MD, Ryo Saito MD, Hiroki Shimizu PhD, MD, Shinji Furuya PhD, MD, Naohiro Hosomura PhD, MD, Hidetake Amemiya PhD, MD, Hiromichi Kawaida PhD, MD, Makoto Sudo PhD, MD, Shingo Inoue PhD, MD, Hiroshi Kono PhD, MD & Daisuke Ichikawa PhD, MD

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  1. Suguru Maruyama PhD, MD
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  2. Yoshihiko Kawaguchi PhD, MD
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  3. Hidenori Akaike PhD, MD
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Corresponding author

Correspondence to Daisuke Ichikawa PhD, MD.

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Supplemental Fig.

 1 Kaplan–Meier curves for overall survival rates and disease-free survival rates. **p < 0.01 compared with complication (−) group using the log-rank test. ***p < 0.005 compared with complication (−) group using the log-rank test (TIFF 2025 kb)

Supplemental Fig.

 2 (a) Quantification of TLC between pre-NAC and post-NAC. The lines represent the median size. (b) Kaplan–Meier curves of patients that performed NAC with high TLC group. (c) Kaplan–Meier curves of patients that performed NAC with low TLC group. *p < 0.05 compared with complication (−) group using the log-rank test. **p < 0.01 compared with complication (−) group using the log-rank test. TLC total lymphocyte count; NAC neoadjuvant chemotherapy (TIFF 2025 kb)

Supplementary material 3 (DOCX 20 kb)

Supplementary material 4 (DOCX 22 kb)

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Maruyama, S., Kawaguchi, Y., Akaike, H. et al. Postoperative Complications have Minimal Impact on Long-Term Prognosis in Immunodeficient Patients with Esophageal Cancer. Ann Surg Oncol 27, 3064–3070 (2020). https://doi.org/10.1245/s10434-020-08245-8

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  • DOI: https://doi.org/10.1245/s10434-020-08245-8

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