Which is a more reliable indicator of survival after gastric cancer surgery: Postoperative complication occurrence or C-reactive protein elevation?

Takuro Saito, Yukinori Kurokawa, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

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 (CRPmax): low (<12 mg/dl) and high CRPmax (≥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 CRPmax group had significantly worse RFS than those in the low CRPmax 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.

Original languageEnglish
Pages (from-to)894-899
Number of pages6
JournalJournal of Surgical Oncology
Volume112
Issue number8
DOIs
Publication statusPublished - Dec 15 2015

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C-Reactive Protein
Stomach Neoplasms
Survival
Recurrence
Multivariate Analysis
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Which is a more reliable indicator of survival after gastric cancer surgery : Postoperative complication occurrence or C-reactive protein elevation? / Saito, Takuro; Kurokawa, Yukinori; Miyazaki, Yasuhiro; Makino, Tomoki; Takahashi, Tsuyoshi; Yamasaki, Makoto; Nakajima, Kiyokazu; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro.

In: Journal of Surgical Oncology, Vol. 112, No. 8, 15.12.2015, p. 894-899.

Research output: Contribution to journalArticle

Saito, T, Kurokawa, Y, Miyazaki, Y, Makino, T, Takahashi, T, Yamasaki, M, Nakajima, K, Takiguchi, S, Mori, M & Doki, Y 2015, 'Which is a more reliable indicator of survival after gastric cancer surgery: Postoperative complication occurrence or C-reactive protein elevation?', Journal of Surgical Oncology, vol. 112, no. 8, pp. 894-899. https://doi.org/10.1002/jso.24067
Saito, Takuro ; Kurokawa, Yukinori ; Miyazaki, Yasuhiro ; Makino, Tomoki ; Takahashi, Tsuyoshi ; Yamasaki, Makoto ; Nakajima, Kiyokazu ; Takiguchi, Shuji ; Mori, Masaki ; Doki, Yuichiro. / Which is a more reliable indicator of survival after gastric cancer surgery : Postoperative complication occurrence or C-reactive protein elevation?. In: Journal of Surgical Oncology. 2015 ; Vol. 112, No. 8. pp. 894-899.
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abstract = "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 (CRPmax): low (<12 mg/dl) and high CRPmax (≥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 CRPmax group had significantly worse RFS than those in the low CRPmax 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.",
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AU - Makino, Tomoki

AU - Takahashi, Tsuyoshi

AU - Yamasaki, Makoto

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N2 - 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 (CRPmax): low (<12 mg/dl) and high CRPmax (≥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 CRPmax group had significantly worse RFS than those in the low CRPmax 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.

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