Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.
World J Surg. 2019 Jul;43(7):1756-1765. doi: 10.1007/s00268-019-04965-5.
There is a lack of data on the effect of high postoperative body temperature on disease-free survival (DFS) in patients who underwent radical gastrectomy.
Patients who underwent radical gastrectomy from January 2006 to December 2011 were selected. The highest body temperature within 1 week after operation was used to establish diagnostic thresholds for high and low body temperature through X-tile software.
A total of 1396 patients were included in the analysis. The diagnostic threshold for high body temperature was defined as 38 °C; 370 patients were allocated to the high-temperature group (HTG), while another 1026 patients were allocated to the low-temperature group (LTG). For all patients, survival analysis showed that 5-year DFS in the HTG was significantly lower than that for the LTG (55.6% vs 63.9%, P = 0.007). Multivariate analysis revealed that high postoperative body temperature was an independent prognostic risk factor for 5-year DFS (HR = 1.288 (1.067-1.555), P = 0.008). For patients without complications, survival analysis showed that the 5-year DFS rate in the HTG was lower than that for the LTG (57.5% vs 64.4%, P = 0.051), especially in patients with stage III gastric cancer (31.3% vs 41.7%, P = 0.037). For patients with complications or infectious complications, there were no significant differences between the HTG and LTG regarding 5-year DFS (49.3% vs 58.2%, P = 0.23 and 49.4% vs 55.1%, P = 0.481, respectively).
For stage III gastric cancer patients without complications, high postoperative body temperature can significantly reduce the 5-year DFS. These patients may benefit from more aggressive adjuvant therapy and postoperative surveillance regimens.
根治性胃切除术后患者术后高体温对无病生存（DFS）的影响数据缺乏。
选择 2006 年 1 月至 2011 年 12 月期间接受根治性胃切除术的患者。通过 X-tile 软件，使用术后 1 周内的最高体温来建立高低体温的诊断阈值。
共纳入 1396 例患者。将高温定义为 38°C；370 例患者归入高温组（HTG），1026 例归入低温组（LTG）。所有患者的生存分析显示，HTG 的 5 年 DFS 明显低于 LTG（55.6%比 63.9%，P=0.007）。多因素分析显示，术后高体温是 5 年 DFS 的独立预后危险因素（HR=1.288（1.067-1.555），P=0.008）。对于无并发症的患者，生存分析显示 HTG 的 5 年 DFS 率低于 LTG（57.5%比 64.4%，P=0.051），尤其是在 III 期胃癌患者中（31.3%比 41.7%，P=0.037）。对于有并发症或感染性并发症的患者，HTG 和 LTG 之间的 5 年 DFS 无显著差异（49.3%比 58.2%，P=0.23 和 49.4%比 55.1%，P=0.481）。
对于无并发症的 III 期胃癌患者，术后高体温可显著降低 5 年 DFS。这些患者可能受益于更积极的辅助治疗和术后监测方案。
