Abstract
Background
Postoperative infection after pancreatectomy in patients with pancreatic cancer often
leads to poor prognosis. The aim of this study was to determine the prognostic effect
of postoperative infection in patients with pancreatic cancer.
Methods
A multicenter cohort study was performed using a common database of patients with
pancreatic cancer who underwent curative pancreatic resections between April 2013
and March 2015 at 15 high-volume centers in Japan. The rate of postoperative infection
was determined, and patient demographic characteristics, clinicopathologic factors,
and prognostic factors for overall survival were analyzed.
Results
Of the 462 eligible patients who underwent curative pancreatectomy, postoperative
infection occurred in 141 patients (31%), including 114 surgical site infections (25%),
50 remote infections (11%), and 23 combined infections (5%). Risk factors for postoperative
infection included high body mass index, nondiabetes, and longer operation time. In
the survival analysis, patients with postoperative infection had significantly worse
overall survival than patients without postoperative infection. The median survival
times were 21.9 and 33.0 months (P = .023), respectively, for patients with and without postoperative infection. According
to the multivariate analysis for overall survival, lack of adjuvant therapy (P = .002), but not postoperative infection (P = .829), predicted poor prognosis. The multivariate analysis revealed that postoperative
infection (P < .001) was an independent risk factor for lack of adjuvant therapy.
Conclusion
Postoperative infection in patients with pancreatic cancer may indirectly worsen the
prognosis by preventing timely adjuvant therapy.
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Article info
Publication history
Published online: October 25, 2022
Accepted:
September 1,
2022
Footnotes
Conception/design (K. Okada, K. Uemura, S. Akagi, T. Inoue, M. Kobayashi, H. Shiomi H, A. Matsuda, M. Watanabe, K. Tanemoto, and H. Maruyama); data acquisition (all authors); data interpretation (all authors); critical revisions (all authors); and final approval (all authors). All individuals claiming authorship meet all of the following 3 conditions: (1) authors made substantial contributions to conception and design and/or acquisition of data and/or analysis and interpretation of data; (2) authors participated in drafting the article or revising it critically for important intellectual content; and (3) authors gave final approval of the version to be published.
Identification
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