Infectious Complications after Surgery for Gastrointestinal Malignancy Affect the Clinical Outcome

Hironori Tsujimoto, Shuichi Hiraki, Naoko Sakamoto, Yoshihisa Yaguchi, Takuya Horio, Satoshi Aiko, Satoshi Ono*, Takashi Ichikura, Junji Yamamoto and Kazuo Hase

Department of Surgery, National Defense Medical College
Division of Basic Traumatology, National Defense Medical College Research Institute*

Postoperative nosocomial infection is the most frequent complication following gastrointestinal cancer surgery; despite considerable advances in the areas of perioperative management. Postoperative surgical and medical complications are negative predictors in long-term malignancy outcome. We reviewed publications on the impact of postoperative infection on long-term post-cancer-surgery survival. Evidence is increasing that in the cases of solid cancers, postoperative complications, especially those caused by infection, are associated significantly with negative long-term outcomes. Although the precise nature of their association remains unclear, several possible mechanisms have been proposed: (1) cytokine and chemokine enhancement during infection, (2) deregulated immunosuppressive factors induced by infection, and (3) microbial components that may directly activate cancer cell proliferation and metastatic potential. In conclusion, we emphasize the importance of preventing postoperative infection in improving the clinical outcome of gastrointestinal malignancy.

Key words
postoperative infectious complication, prognosis, immunosuppression

Reprint requests
Hironori Tsujimoto Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359-8513 JAPAN

Accepted
November 18, 2009

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