Takashi Nojiri1,2,3, Toshimitsu Hamasaki4, Masayoshi Inoue5, Yasushi Shintani5, Yukiyasu Takeuchi6, Hajime Maeda6, Meinoshin Okumura5. 1. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp. 2. Department of Biochemistry, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp. 3. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan. nojirit@thoracic.med.osaka-u.ac.jp. 4. Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. 5. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. 6. Department of General Thoracic Surgery, National Hospital Organization Toneyama Hospital, Toyonaka, Osaka, Japan.
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.
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: Jessica R Glover; Frank O Velez-Cubian; Wei Wei Zhang; Kavian Toosi; Tawee Tanvetyanon; Emily P Ng; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza Journal: J Thorac Dis Date: 2016-12 Impact factor: 2.895
Authors: Roni F Rayes; Phil Vourtzoumis; Marianne Bou Rjeily; Rashmi Seth; France Bourdeau; Betty Giannias; Julie Berube; Yu-Hwa Huang; Simon Rousseau; Sophie Camilleri-Broet; Richard S Blumberg; Nicole Beauchemin; Sara Najmeh; Jonathan Cools-Lartigue; Jonathan D Spicer; Lorenzo E Ferri Journal: J Immunol Date: 2020-03-13 Impact factor: 5.422