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Quantitative Evaluation of Periodontitis for Predicting the Occurrence of Postoperative Pneumonia After Oncologic Esophagectomy

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

Abstract

Background

Periodontitis is a biofilm-associated inflammatory periodontal disease associated with postoperative complications after esophagectomy. However, few studies have evaluated the inflammatory burden posed by periodontitis quantitively for patients undergoing oncologic esophagectomy. This study aimed to clarify the relationship between periodontitis and postoperative pneumonia using periodontal inflammatory surface area (PISA).

Methods

The study analyzed 251 patients who underwent esophagectomy for esophageal cancer. The patients were classified into low-PISA and high-PISA groups according to preoperative PISA, and the relationship between the occurrence and severity of postoperative pneumonia was investigated.

Results

The high-PISA group (n = 69) included more males (P < 0.001) and patients with poor performance status (P < 0.024). Postoperative pneumonia occurred more frequently in the high-PISA group than in the low-PISA group (31.9 % vs. 15.9 %; P = 0.008), whereas the incidences of other complications did not differ significantly. In addition, the incidence of severe pneumonia was significantly higher in the high-PISA group (7.2 % vs. 1.6 %; P = 0.038). In the multivariable analysis for adjustment of preoperative confounders, age older than 70 years (odds ratio [OR], 2.62; P = 0.006), high PISA (OR, 2.45; P = 0.012), and smoking history (OR, 2.78; P = 0.006) were the independent variables predicting postoperative pneumonia.

Conclusion

Preoperative higher PISA was significantly associated with the occurrence of overall and severe postoperative pneumonia. The quantitative evaluation of periodontitis using PISA is a useful measure for predicting postoperative pneumonia, and intensive periodontal intervention may contribute to decreasing postoperative pneumonia.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Yasukazu Kanie MD, Akihiko Okamura MD, Jun Kanamori MD, Yu Imamura MD & Masayuki Watanabe MD

  2. Department of Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yasukazu Kanie MD, Jun Kanamori MD & Tomoki Ebata MD

  3. Department of Dentistry, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Ken Tomizuka DDS & Takao Uchiyama DDS

Authors
  1. Yasukazu Kanie MD
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  2. Akihiko Okamura MD
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  3. Ken Tomizuka DDS
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  4. Takao Uchiyama DDS
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  5. Jun Kanamori MD
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  8. Masayuki Watanabe MD
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Correspondence to Akihiko Okamura MD.

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Kanie, Y., Okamura, A., Tomizuka, K. et al. Quantitative Evaluation of Periodontitis for Predicting the Occurrence of Postoperative Pneumonia After Oncologic Esophagectomy. Ann Surg Oncol 30, 8216–8222 (2023). https://doi.org/10.1245/s10434-023-14030-0

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