Association between postoperative complications and clinical cancer outcomes.
BACKGROUND
The treatment for a majority of solid organ tumors is surgical resection; 10-20 % of patients suffer a perioperative complication. Perioperative complications may contribute to cancer recurrence. This study examined the relationship between postoperative complications and risk-adjusted patient overall survival.


METHODS
Data from 2003 to 2009 were linked from our clinical cancer registry, the National Surgery Quality Improvement Project (NSQIP), and medical records. Patients who had tumor extirpation for cure were included. The NSQIP was used to identify complications. Patients with a complication were matched to patients without a complication. χ (2) tests and Cox proportional hazard regression models were used.


RESULTS
A total of 415 patients were included for survival analysis. The hazard ratio (HR) for mortality associated with having a complication was 2.17. The HR for mortality after 200 days postoperatively was 2.47. Infectious complications were associated with the highest association with increased mortality (HR = 3.56). Noninfectious complications were not associated with an increased risk of mortality.


CONCLUSIONS
This study investigated the relationship of surgical infectious complications in cancer patients with long-term survival for patients who had a number of different types of cancer. After taking into account the site, histology, and stage of the cancer, we found that patients with infectious complications had earlier death.
Department of Surgery, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112-5550, USA, courtney.scaife@hci.utah.edu.
Courtney L
CL
Scaife
Arthur
A
Hartz
Lisa
L
Pappas
Peter
P
Pelletier
Tao
T
He
Robert E
RE
Glasgow
Sean J
SJ
Mulvihill
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D015996:Survival Rate; D055815:Young Adult