TY - JOUR
T1 - Prognostic impact of postoperative infection in patients with pancreatic cancer
T2 - A multicenter cohort study
AU - Okada, Kenjiro
AU - Uemura, Kenichiro
AU - Ohge, Hiroki
AU - Iseki, Masahiro
AU - Mizuma, Masamichi
AU - Shinkawa, Hiroji
AU - Takahata, Risa
AU - Aoki, Taku
AU - Makino, Kenta
AU - Arai, Hiroki
AU - Miyake, Toru
AU - Takeda, Shigeru
AU - Yokoyama, Yasuyuki
AU - Yaguchi, Yoshihisa
AU - Kobayashi, Minako
AU - Matsuda, Akihisa
AU - Shiomi, Hisanori
AU - Watanabe, Manabu
AU - Akagi, Shinji
AU - Inoue, Toru
AU - Tanemoto, Kazuo
AU - Maruyama, Hiroshi
N1 - Funding Information:
We would like to recognize the following people and their respective institutions for their leadership, data acquisition, and noteworthy contributions to this collaborative effort: Shinya Kusachi, MD, Department of Surgery, Tohokamagaya Hospital, Chiba, Japan, and Yuko Kitagawa, MD, Department of Surgery, Keio University School of Medicine, Tokyo, Japan, All patients provided informed consent before surgery. The protocol for this research project has been approved by the institutional review board of Hiroshima University and a suitably constituted ethics committee of the institution, and it conforms to the provisions of the Declaration of Helsinki.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/12
Y1 - 2022/12
N2 - 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.
AB - 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.
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U2 - 10.1016/j.surg.2022.09.002
DO - 10.1016/j.surg.2022.09.002
M3 - Article
C2 - 36307331
AN - SCOPUS:85141822240
SN - 0039-6060
VL - 172
SP - 1768
EP - 1775
JO - Surgery (United States)
JF - Surgery (United States)
IS - 6
ER -
