Nakashima Chiyo, Iida Michihisa, Nishiyama Mitsuo, Watanabe Yusaku, Shindo Yoshitaro, Tokumitsu Yukio, Tomochika Shinobu, Nakagami Yuki, Takahashi Hidenori, Nagano Hiroaki
Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
Department of Data Science, Faculty of Data Science, Shimonoseki City University, Shimonoseki, Yamaguchi 751-8510, Japan.
Oncol Lett. 2024 Sep 26;28(6):562. doi: 10.3892/ol.2024.14695. eCollection 2024 Dec.
Infectious complications (ICs) have been reported as major causes of postoperative mortality in patients with cancer. However, to the best of our knowledge, the impact of ICs after gastrectomy on non-gastric cancer-related deaths (NGCDs) remains unexplored. The present study aimed to identify the impact of ICs after gastrectomy on NGCDs. A retrospective analysis of 712 patients with gastric cancer who underwent curative gastrectomy was conducted. The participants were categorized into IC and non-IC groups based on the incidence of postoperative IC. Clinicopathological factors and non-gastric cancer-related survival (NGCS) rates were compared between groups. Further NGCD and associated risk factor analyses were performed in a background factor-adjusted cohort using multivariate analysis. Among the 712 patients, 112 developed ICs (Clavien-Dindo classification grade ≥II). In the entire cohort, the IC group had a significantly worse 5-year cumulative incidence of NGCD (17.8 vs. 10.6%; Gray's P=0.021) compared with the non-IC group. Although a number of clinicopathological factors differed between the groups, including patient background, operative factors and tumor factors, the risk factors for NGCD identified in the multivariate analysis were older age, low prognostic nutritional index, low skeletal muscle index and Charlson comorbidity index ≥1, excluding IC incidents. The IC group exhibited more background factors contributing to NGCDs, suggesting a potential increase in NGCD regardless of IC incidence.
感染性并发症（ICs）已被报道为癌症患者术后死亡的主要原因。然而，据我们所知，胃切除术后ICs对非胃癌相关死亡（NGCDs）的影响仍未得到探索。本研究旨在确定胃切除术后ICs对NGCDs的影响。对712例行根治性胃切除术的胃癌患者进行了回顾性分析。根据术后ICs的发生率将参与者分为IC组和非IC组。比较两组的临床病理因素和非胃癌相关生存率（NGCS）。在背景因素调整队列中使用多变量分析进行进一步的NGCD及相关危险因素分析。在712例患者中，112例发生了ICs（Clavien-Dindo分级≥II级）。在整个队列中，与非IC组相比，IC组的5年NGCD累积发生率显著更高（17.8%对10.6%；Gray检验P = 0.021）。尽管两组之间存在许多临床病理因素差异，包括患者背景、手术因素和肿瘤因素，但多变量分析确定的NGCD危险因素为年龄较大、预后营养指数低、骨骼肌指数低和Charlson合并症指数≥1，不包括IC事件。IC组显示出更多导致NGCDs的背景因素，这表明无论IC发生率如何，NGCDs都可能增加。
