Department of Surgery, Zealand University Hospital Køge/Roskilde, Køge, Denmark.
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
Br J Surg. 2020 Feb;107(3):310-315. doi: 10.1002/bjs.11372. Epub 2019 Nov 22.
Systemic inflammation following curative surgery for colorectal cancer may be associated with increased risk of recurrence. [Correction added on 29 November 2019, after first online publication: text amended for accuracy.] This study investigated whether a clinically suspected infection, for which blood cultures were sent within 30 days after surgery for colorectal cancer, was associated with long-term oncological outcomes.
This register-based national cohort study included all Danish residents undergoing surgery with curative intent for colorectal cancer between January 2003 and December 2013. Patients who developed recurrence or died within 180 days after surgery were not included. Associations between blood cultures taken within 30 days after primary surgery and overall survival, disease-free survival and recurrence-free survival were analysed using Cox regression models adjusted for relevant clinical confounders, including demographic data, cancer stage, co-morbidity, blood transfusion, postoperative complications and adjuvant chemotherapy.
The study included 21 349 patients, of whom 3390 (15·9 per cent) had blood cultures taken within 30 days after surgery. Median follow-up was 5·6 years. Patients who had blood cultures taken had an increased risk of all-cause mortality (hazard ratio (HR) 1·27, 95 per cent c.i. 1·20 to 1·35; P < 0·001), poorer disease-free survival (HR 1·22, 1·16 to 1·29; P < 0·001) and higher risk of recurrence (HR 1·15, 1·07 to 1·23; P < 0·001) than patients who did not have blood cultures taken.
A clinically suspected infection requiring blood cultures within 30 days of surgery for colorectal cancer was associated with poorer oncological outcomes.
结直肠癌根治术后全身炎症可能与复发风险增加有关。[2019 年 11 月 29 日更正：文本经过修正以确保准确性。]本研究调查了在结直肠癌手术后 30 天内送检疑似临床感染的血培养是否与长期肿瘤学结果相关。
本基于登记的全国队列研究纳入了 2003 年 1 月至 2013 年 12 月期间所有接受结直肠癌根治性手术的丹麦居民。未包括术后 180 天内发生复发或死亡的患者。使用 Cox 回归模型分析术后 30 天内进行血培养与总生存期、无病生存期和无复发生存期之间的关系，模型调整了包括人口统计学数据、癌症分期、合并症、输血、术后并发症和辅助化疗在内的相关临床混杂因素。
研究纳入了 21349 例患者，其中 3390 例（15.9%）在术后 30 天内进行了血培养。中位随访时间为 5.6 年。进行血培养的患者全因死亡率增加（风险比（HR）1.27，95%置信区间（CI）1.20 至 1.35；P<0.001）、无病生存期更差（HR 1.22，1.16 至 1.29；P<0.001）和复发风险更高（HR 1.15，1.07 至 1.23；P<0.001），而非进行血培养的患者。
在结直肠癌手术后 30 天内送检疑似临床感染的血培养与较差的肿瘤学结果相关。
