Prognostic impact of postoperative infection in patients with pancreatic cancer: A multicenter cohort study

Kenjiro Okada, Kenichiro Uemura, Hiroki Ohge, Masahiro Iseki, Masamichi Mizuma, Hiroji Shinkawa, Risa Takahata, Taku Aoki, Kenta Makino, Hiroki Arai, Toru Miyake, Shigeru Takeda, Yasuyuki Yokoyama, Yoshihisa Yaguchi, Minako Kobayashi, Akihisa Matsuda, Hisanori Shiomi, Manabu Watanabe, Shinji Akagi, Toru InoueKazuo Tanemoto, Hiroshi Maruyama

Research output: Contribution to journalArticlepeer-review


Background: Postoperative infection after pancreatectomy in patients with pancreatic cancer often leads to poor prognosis. The aim of this study was to determine the prognostic effect of postoperative infection in patients with pancreatic cancer. Methods: A multicenter cohort study was performed using a common database of patients with pancreatic cancer who underwent curative pancreatic resections between April 2013 and March 2015 at 15 high-volume centers in Japan. The rate of postoperative infection was determined, and patient demographic characteristics, clinicopathologic factors, and prognostic factors for overall survival were analyzed. Results: Of the 462 eligible patients who underwent curative pancreatectomy, postoperative infection occurred in 141 patients (31%), including 114 surgical site infections (25%), 50 remote infections (11%), and 23 combined infections (5%). Risk factors for postoperative infection included high body mass index, nondiabetes, and longer operation time. In the survival analysis, patients with postoperative infection had significantly worse overall survival than patients without postoperative infection. The median survival times were 21.9 and 33.0 months (P = .023), respectively, for patients with and without postoperative infection. According to the multivariate analysis for overall survival, lack of adjuvant therapy (P = .002), but not postoperative infection (P = .829), predicted poor prognosis. The multivariate analysis revealed that postoperative infection (P < .001) was an independent risk factor for lack of adjuvant therapy. Conclusion: Postoperative infection in patients with pancreatic cancer may indirectly worsen the prognosis by preventing timely adjuvant therapy.

Original languageEnglish
Pages (from-to)1768-1775
Number of pages8
JournalSurgery (United States)
Issue number6
Publication statusPublished - 2022 Dec

ASJC Scopus subject areas

  • Surgery


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