Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer: Exploratory Analysis of JCOG9907

Kozo Kataoka, Hiroya Takeuchi, Junki Mizusawa, Hiroyasu Igaki, Soji Ozawa, Tetsuya Abe, Kenichi Nakamura, Ken Kato, Nobutoshi Ando, Yuukou Kitagawa

研究成果: Article

38 引用 (Scopus)

抄録

OBJECTIVE:: To investigate the influence of infectious complications on the outcome of current standard preoperative chemotherapy followed by surgery for clinical stage II/III esophageal cancer. BACKGROUND:: The impact of postoperative infectious complications on survival after transthoracic esophagectomy remains controversial. METHODS:: Data from a randomized controlled trial (JCOG9907) were used. Infectious complications were classified into three groups: pneumonia, anastomotic leakage, and others. Univariate and multivariate analyses using the Cox proportional hazard model were performed. RESULTS:: Among the 152 analyzed patients, the incidence of pneumonia, leakage, and overall infectious complication were 22 (14%), 21 (14%), and 54 (36%). Overall survival (OS) of patients with any infectious complication was shorter than that of patients without infectious complication [hazard ratio, HR 1.66, 95% confidence interval, CI, (1.02–2.71)] and progression-free survival (PFS) also tended to be shorter in patients with any infectious complication [HR 1.44, (0.92–2.24)]. The OS of patients with pneumonia was shorter than that of patients without pneumonia [HR 1.82, (1.01–3.29)], and PFS also tended to be shorter in patients with pneumonia [HR 1.50, (0.85–2.62)]. The OS of patients with anastomotic leakage (n = 21) was nearly identical to that for patients without leakage [HR 1.06, (0.52–2.13)] and PFS showed the same tendency [HR 1.28, (0.71–2.32)]. Multivariate analysis revealed that pneumonia tended to compromise OS and PFS [HR 1.66, (0.87–3.17) and HR 1.37, (0.75–2.51)]. CONCLUSIONS:: These results indicate that postoperative infectious complications may worsen patient prognosis after esophagectomy. Performing esophagectomy without postoperative complications, especially pneumonia, may be beneficial for improving survival outcomes.

元の言語English
ジャーナルAnnals of Surgery
DOI
出版物ステータスAccepted/In press - 2016 6 8

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Esophagectomy
Esophageal Neoplasms
Morbidity
Pneumonia
Disease-Free Survival
Survival
Anastomotic Leak
Multivariate Analysis
Proportional Hazards Models
Randomized Controlled Trials
Confidence Intervals
Drug Therapy

ASJC Scopus subject areas

  • Surgery

これを引用

Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer : Exploratory Analysis of JCOG9907. / Kataoka, Kozo; Takeuchi, Hiroya; Mizusawa, Junki; Igaki, Hiroyasu; Ozawa, Soji; Abe, Tetsuya; Nakamura, Kenichi; Kato, Ken; Ando, Nobutoshi; Kitagawa, Yuukou.

:: Annals of Surgery, 08.06.2016.

研究成果: Article

Kataoka, Kozo ; Takeuchi, Hiroya ; Mizusawa, Junki ; Igaki, Hiroyasu ; Ozawa, Soji ; Abe, Tetsuya ; Nakamura, Kenichi ; Kato, Ken ; Ando, Nobutoshi ; Kitagawa, Yuukou. / Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer : Exploratory Analysis of JCOG9907. :: Annals of Surgery. 2016.
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title = "Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer: Exploratory Analysis of JCOG9907",
abstract = "OBJECTIVE:: To investigate the influence of infectious complications on the outcome of current standard preoperative chemotherapy followed by surgery for clinical stage II/III esophageal cancer. BACKGROUND:: The impact of postoperative infectious complications on survival after transthoracic esophagectomy remains controversial. METHODS:: Data from a randomized controlled trial (JCOG9907) were used. Infectious complications were classified into three groups: pneumonia, anastomotic leakage, and others. Univariate and multivariate analyses using the Cox proportional hazard model were performed. RESULTS:: Among the 152 analyzed patients, the incidence of pneumonia, leakage, and overall infectious complication were 22 (14{\%}), 21 (14{\%}), and 54 (36{\%}). Overall survival (OS) of patients with any infectious complication was shorter than that of patients without infectious complication [hazard ratio, HR 1.66, 95{\%} confidence interval, CI, (1.02–2.71)] and progression-free survival (PFS) also tended to be shorter in patients with any infectious complication [HR 1.44, (0.92–2.24)]. The OS of patients with pneumonia was shorter than that of patients without pneumonia [HR 1.82, (1.01–3.29)], and PFS also tended to be shorter in patients with pneumonia [HR 1.50, (0.85–2.62)]. The OS of patients with anastomotic leakage (n = 21) was nearly identical to that for patients without leakage [HR 1.06, (0.52–2.13)] and PFS showed the same tendency [HR 1.28, (0.71–2.32)]. Multivariate analysis revealed that pneumonia tended to compromise OS and PFS [HR 1.66, (0.87–3.17) and HR 1.37, (0.75–2.51)]. CONCLUSIONS:: These results indicate that postoperative infectious complications may worsen patient prognosis after esophagectomy. Performing esophagectomy without postoperative complications, especially pneumonia, may be beneficial for improving survival outcomes.",
author = "Kozo Kataoka and Hiroya Takeuchi and Junki Mizusawa and Hiroyasu Igaki and Soji Ozawa and Tetsuya Abe and Kenichi Nakamura and Ken Kato and Nobutoshi Ando and Yuukou Kitagawa",
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T1 - Prognostic Impact of Postoperative Morbidity After Esophagectomy for Esophageal Cancer

T2 - Exploratory Analysis of JCOG9907

AU - Kataoka, Kozo

AU - Takeuchi, Hiroya

AU - Mizusawa, Junki

AU - Igaki, Hiroyasu

AU - Ozawa, Soji

AU - Abe, Tetsuya

AU - Nakamura, Kenichi

AU - Kato, Ken

AU - Ando, Nobutoshi

AU - Kitagawa, Yuukou

PY - 2016/6/8

Y1 - 2016/6/8

N2 - OBJECTIVE:: To investigate the influence of infectious complications on the outcome of current standard preoperative chemotherapy followed by surgery for clinical stage II/III esophageal cancer. BACKGROUND:: The impact of postoperative infectious complications on survival after transthoracic esophagectomy remains controversial. METHODS:: Data from a randomized controlled trial (JCOG9907) were used. Infectious complications were classified into three groups: pneumonia, anastomotic leakage, and others. Univariate and multivariate analyses using the Cox proportional hazard model were performed. RESULTS:: Among the 152 analyzed patients, the incidence of pneumonia, leakage, and overall infectious complication were 22 (14%), 21 (14%), and 54 (36%). Overall survival (OS) of patients with any infectious complication was shorter than that of patients without infectious complication [hazard ratio, HR 1.66, 95% confidence interval, CI, (1.02–2.71)] and progression-free survival (PFS) also tended to be shorter in patients with any infectious complication [HR 1.44, (0.92–2.24)]. The OS of patients with pneumonia was shorter than that of patients without pneumonia [HR 1.82, (1.01–3.29)], and PFS also tended to be shorter in patients with pneumonia [HR 1.50, (0.85–2.62)]. The OS of patients with anastomotic leakage (n = 21) was nearly identical to that for patients without leakage [HR 1.06, (0.52–2.13)] and PFS showed the same tendency [HR 1.28, (0.71–2.32)]. Multivariate analysis revealed that pneumonia tended to compromise OS and PFS [HR 1.66, (0.87–3.17) and HR 1.37, (0.75–2.51)]. CONCLUSIONS:: These results indicate that postoperative infectious complications may worsen patient prognosis after esophagectomy. Performing esophagectomy without postoperative complications, especially pneumonia, may be beneficial for improving survival outcomes.

AB - OBJECTIVE:: To investigate the influence of infectious complications on the outcome of current standard preoperative chemotherapy followed by surgery for clinical stage II/III esophageal cancer. BACKGROUND:: The impact of postoperative infectious complications on survival after transthoracic esophagectomy remains controversial. METHODS:: Data from a randomized controlled trial (JCOG9907) were used. Infectious complications were classified into three groups: pneumonia, anastomotic leakage, and others. Univariate and multivariate analyses using the Cox proportional hazard model were performed. RESULTS:: Among the 152 analyzed patients, the incidence of pneumonia, leakage, and overall infectious complication were 22 (14%), 21 (14%), and 54 (36%). Overall survival (OS) of patients with any infectious complication was shorter than that of patients without infectious complication [hazard ratio, HR 1.66, 95% confidence interval, CI, (1.02–2.71)] and progression-free survival (PFS) also tended to be shorter in patients with any infectious complication [HR 1.44, (0.92–2.24)]. The OS of patients with pneumonia was shorter than that of patients without pneumonia [HR 1.82, (1.01–3.29)], and PFS also tended to be shorter in patients with pneumonia [HR 1.50, (0.85–2.62)]. The OS of patients with anastomotic leakage (n = 21) was nearly identical to that for patients without leakage [HR 1.06, (0.52–2.13)] and PFS showed the same tendency [HR 1.28, (0.71–2.32)]. Multivariate analysis revealed that pneumonia tended to compromise OS and PFS [HR 1.66, (0.87–3.17) and HR 1.37, (0.75–2.51)]. CONCLUSIONS:: These results indicate that postoperative infectious complications may worsen patient prognosis after esophagectomy. Performing esophagectomy without postoperative complications, especially pneumonia, may be beneficial for improving survival outcomes.

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