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Which is a more reliable indicator of survival after gastric cancer surgery: Postoperative complication occurrence or C‐reactive protein elevation?
Author(s) -
Saito Takuro,
Kurokawa Yukinori,
Miyazaki Yasuhiro,
Makino Tomoki,
Takahashi Tsuyoshi,
Yamasaki Makoto,
Nakajima Kiyokazu,
Takiguchi Shuji,
Mori Masaki,
Doki Yuichiro
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24067
Subject(s) - medicine , complication , multivariate analysis , univariate analysis , cancer , surgery , c reactive protein , gastroenterology , inflammation
Background and Objectives The impact of postoperative complications on long‐term outcome has been reported in several types of malignancies. However, it is unclear why postoperative complications affect long‐term outcome. The aim of this study is evaluating whether postoperative complication occurrence or C‐reactive protein (CRP) elevation better reflects long‐term outcome in gastric cancer patients. Methods This study included 305 patients who underwent curative surgery for pT2–T4b gastric cancer. Patients were divided into two groups based on the peak CRP value (CRP max ): low (<12 mg/dl) and high CRP max (≥12 mg/dl). A multivariate analysis was conducted to identify independent prognostic factors for recurrence‐free survival (RFS). Results Postoperative complications (≥Grade II) occurred in 86 of 305 patients (28.2%). Although CRP elevation ( P = 0.001) and postoperative complication occurrence ( P = 0.045) was each significantly associated with RFS in the univariate analysis, multivariate analysis identified CRP elevation ( P = 0.017) but not complication occurrence ( P = 0.682) as an independent prognostic factor. Among patients without complications, those in the high CRP max group had significantly worse RFS than those in the low CRP max group ( P = 0.004). Conclusions CRP elevation is a more reliable indicator of survival after gastric cancer surgery than postoperative complication occurrence. Surgeons should minimize the postoperative inflammatory response to improve prognosis. J. Surg. Oncol. 2015;112:894–899 . © 2015 Wiley Periodicals, Inc.