Impact of postoperative complications on long-term survival of gastric cancer patients: results from a high-volume institution in China

Abstract BackgroundThis study was aimed to evaluate the impact of postoperative complications (POCs) on long-term survival for gastric cancer (GC) patients with curative resection.MethodsFrom January 2009 to December 2014, a total of 1667 GC patients with curative gastrectomy were analyzed. Patients with any complications Clavien–Dindo (CD) grade II or higher were divided into complication group. Independent risk factors for the development of POCs and the relationship between POCs and long-term survival (excluding death within 90 days after surgery) were analyzed.ResultsOverall POCs CD ≥ 2 were diagnosed in 285 (17.10%) patients including infectious complications (ICs) in 231 (13.9%) and noninfectious complications (NICs) in 78 (4.68%) patients. Age ≥ 65 (P = 0.003), presence of comorbidity (P = 0.019), extensive lymphadenectomy (P = 0.027) and perioperative blood transfusion (P = 0.040) were independent risk factors of POCs. Multivariate analysis identified that presence of POCs (P < 0.001) was an independent prognostic factor and further analysis by complication type demonstrated that the deteriorated overall survival was mainly caused by ICs (P = 0.007) rather than NICs (P = 0.075), moreover, among all complications, pulmonary infection (P < 0.001) was the only significant prognostic factor.ConclusionPOCs may be an independent prognostic factor for long-term survival of GC patients and the risk is mainly driven by ICs, particular pulmonary infection.