演題番号 : O85-3
Postoperative complications have been shown to worsen long-term prognosis in various cancers. It is considered that high inflammatory response associated with complications affect the cancer progression. However, it has been reported that postoperative complications have a lesser impact on the prognosis in patients undergoing total gastrectomy with splenectomy. We hypothesized that immunosuppression due to splenectomy would have this impact, and examined the prognosis in gastric cancer patients with immunosuppression and aimed to prove this hypothesis.
Patient and methods
We retrospectively assessed 306 patients who underwent curative resection without splenectomy for gastric cancer in our hospital from 2008 to 2015. We used the lymphocyte count of 697/㎕derived from the ROC curve as a cut-off value, and divided the low lymphocyte group and high lymphocyte group. We compared the relationship between lymphocyte count, clinicopathological factors, and overall survival (OS) and progression free survival (PFS).
Of the total 306 patients, 12 (3.9%) and 294 (96.1%) were in the low and high lymphocyte group. Age was significantly higher in the low lymphocyte group (p=0.014), but there was no difference in other clinicopathological factors. 33.3% of low lymphocyte group and 14.7% of the high lymphocyte group had Clavien-Dindo Ⅱ or higher complications. In the low lymphocyte group, complications did not affect long term prognosis. On the other hand, 5-year OS rate of group with complications (63.3%) was significantly lower than that of group with no complication (79.6%) (p=0.039) in high lymphocyte group. 5-year PFS rate was relatively lower in the group with complications.
It is suggested that post-operative complications may have less impact on long term prognosis in immunosuppressed patients in gastric cancer.