Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 19:2018:4396018.
doi: 10.1155/2018/4396018. eCollection 2018.

Comprehensive Complication Index Predicts Cancer-Specific Survival of Patients with Postoperative Complications after Curative Resection of Gastric Cancer

Ru-Hong Tu  1   2 , Jian-Xian Lin  1   2 , Ping Li  1   2 , Jian-Wei Xie  1   2 , Jia-Bin Wang  1   2 , Jun Lu  1   2 , Qi-Yue Chen  1   2 , Long-Long Cao  1   2 , Mi Lin  1   2 , Chao-Hui Zheng  1   2   3   4 , Chang-Ming Huang  1   2   3   4
Affiliations

Comprehensive Complication Index Predicts Cancer-Specific Survival of Patients with Postoperative Complications after Curative Resection of Gastric Cancer

Ru-Hong Tu et al. Gastroenterol Res Pract. .

Abstract

Objective: To investigate the prognostic impact of postoperative complications for patients with gastric cancer.

Methods: Postoperative complications of patients undergoing radical gastrectomy for gastric cancer were reviewed. The severity of complications was graded by the CCI and C-D classification.

Results: A total of 5327 patients were included in the study. Complications were observed in 767 patients. When the C-D classification system was applied, for patients with grade I-II complications, the length of stay (LOS) of those with high CCI (CCI ≥ 26.2) was significantly longer than that of patients with low CCI (CCI < 26.2) (p < 0.001). The 5-year cancer-specific survival rate of patients with complications (52%) was lower than that of patients without complications (61%) (p < 0.001). Analysis of the factors associated with prognosis in patients with gastric cancer revealed that complications were independent risk factors for specific survival. When CCI was used to classify complication severity, the 5-year cancer-specific survival rate of the high-CCI group was 46.3%, which was lower than that of the low-CCI group (54.9%, p = 0.009).

Conclusion: Complication after radical gastrectomy is an independent prognostic factor, and the complication severity as graded by CCI reflects the difference of cancer-specific survival in gastric cancer patients with postoperative complications.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of complication patients by C-D classification and CCI, respectively. (a) Histogram with probability density curve (solid line) of CD grade in patients with postoperative complications after curative resection of gastric cancer. (b) Histogram with probability density curve (solid line) of CCI in patients with postoperative complications after curative resection of gastric cancer. (c) Horizontal bar graphs show the different division by CD grade and CCI.
Figure 2
Figure 2
Kaplan-Meier curves of patients with mild and severe postoperative pneumonia according to CCI and CD grade. (a) Disease-specific survival of patients with postoperative complications measured by CCI (p = 0.009). (b) Disease-specific survival of patients with postoperative complications measured by C-D classification (p = 0.583).
See this image and copyright information in PMC

References

    1. Kim H. H., Hyung W. J., Cho G. S., et al. Morbidity and mortality of laparoscopic gastrectomy versus open gastrectomy for gastric cancer: an interim report—a phase III multicenter, prospective, randomized trial (KLASS Trial) Annals of Surgery. 2010;251(3):417–420. doi: 10.1097/SLA.0b013e3181cc8f6b. - DOI - PubMed
    1. Lee J. H., Han H. S., Lee J. H. A prospective randomized study comparing open vs laparoscopy-assisted distal gastrectomy in early gastric cancer: early results. Surgical Endoscopy. 2005;19(2):168–173. doi: 10.1007/s00464-004-8808-y. - DOI - PubMed
    1. Guzman E. A., Pigazzi A., Lee B., et al. Totally laparoscopic gastric resection with extended lymphadenectomy for gastric adenocarcinoma. Annals of Surgical Oncology. 2009;16(8):2218–2223. doi: 10.1245/s10434-009-0508-3. - DOI - PubMed
    1. Kim M. C., Kim K. H., Kim H. H., Jung G. J. Comparison of laparoscopy-assisted by conventional open distal gastrectomy and extraperigastric lymph node dissection in early gastric cancer. Journal of Surgical Oncology. 2005;91(1):90–94. doi: 10.1002/jso.20271. - DOI - PubMed
    1. Lee J. H., Yom C. K., Han H. S. Comparison of long-term outcomes of laparoscopy-assisted and open distal gastrectomy for early gastric cancer. Surgical Endoscopy. 2009;23(8):1759–1763. doi: 10.1007/s00464-008-0198-0. - DOI - PubMed

LinkOut - more resources