title: Long-Term Impact of Postoperative Complications on Cancer Recurrence Following Lung Cancer Surgery.
abstract: BACKGROUND
  Postoperative complications are associated with poor cancer-specific survival in various types of cancer surgery. Recent studies suggest that systemic inflammation induced by surgical trauma can accelerate the adhesion of circulating tumor cells to the vascular endothelium of distant organs, resulting in early cancer recurrence. We investigated the impact of postoperative cardiopulmonary complications on cancer recurrence following lung cancer surgery.
  
  
  METHODS
  From a prospective database of 675 consecutive patients who underwent curative surgery for lung cancer between 2007 and 2012, the incidence of postoperative cardiopulmonary complications, white blood cell counts, and C-reactive protein levels were evaluated in the acute phase after surgery. Four patients had both cardiovascular and respiratory complications. The remaining 671 patients were divided into 3 groups: patients without cardiopulmonary complications; those with cardiovascular complications; and those with respiratory complications. The incidence of cancer recurrence was compared among the three groups.
  
  
  RESULTS
  Postoperative cardiovascular or respiratory complications were identified in 94 (14%) or 25 (4%) patients, respectively. Postoperative white blood cell counts and C-reactive protein levels were significantly higher in those with postoperative respiratory complications than in those without. There was a significantly higher incidence of cancer recurrence in those with postoperative respiratory complications than in those without (48.0 vs. 16.8%; p < 0.0001). Multiple regression analysis adjusted for age, sex, and pathological staging showed that the incidence of postoperative respiratory complications was a significant predictor of cancer recurrence.
  
  
  CONCLUSIONS
  The presence of respiratory complications following lung cancer surgery was a significant predictor of cancer recurrence.
authors: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp.|Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp.|Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp.
authors: Takashi
authors: T
authors: Nojiri
authors: Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
authors: Toshimitsu
authors: T
authors: Hamasaki
authors: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Masayoshi
authors: M
authors: Inoue
authors: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Yasushi
authors: Y
authors: Shintani
authors: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan.
authors: Yukiyasu
authors: Y
authors: Takeuchi
authors: Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan.
authors: Hajime
authors: H
authors: Maeda
authors: Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
authors: Meinoshin
authors: M
authors: Okumura
mesh_terms: D000210:Acute-Phase Reaction / Q000097:blood / Q000209:etiology*; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007958:Leukocyte Count; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D011184:Postoperative Period; D012140:Respiratory Tract Diseases / Q000097:blood / Q000209:etiology; D013997:Time Factors
chemical_list: D002097:C-Reactive Protein