The impact of abdominal infectious complications after T4 coloncancer resection on the development of abdominal recurrences

Wasmann, K.A.T.G.M. (2017) The impact of abdominal infectious complications after T4 coloncancer resection on the development of abdominal recurrences. thesis, Medicine.

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Abstract

Objective: The aim was to characterize the effect of abdominal infectious complications on the development of abdominal recurrences (i.e. local recurrences and peritoneal carcinomatosis (PC)) after curative intent surgery for T4 colon cancer. Background: For decades it is hypothesized that infection-based immunologic pathways create a favorable environment for colon cancer cell dissemination to the abdominal cavity. Despite the prevalence and impact on prognosis of abdominal recurrences, the pathophysiological mechanisms of its development are still unclear. Methods: This was a retrospective multicenter cohort study of 434 patients who underwent a curative intent primary resection of T4 colon cancer in the UZ Leuven and the St. Antonius Hospital between January 2000 and July 2013. Patients were categorized by abdominal infectious complications, by overall infectious complications, by any postoperative complications, and by severity. Primary outcome was abdominal recurrences, secondary were disease free survival (DFS) and overall survival (OS). Results: Abdominal infectious complications occurred in 15.4%, within these patients the 5-year abdominal recurrence rate was 43.8% compared to 27.9% in patients without abdominal infectious complications. Abdominal infectious complications were significantly associated with abdominal recurrences (HR, 2.105; 95% CI (1.111-3.985)). Other significant risk factors for abdominal recurrences were right-sided tumours (HR, 1.742; 95% (1.061-2.859)) and N2-stage lymph node involvement (HR, 2.363; 95% (1.342-4.159)). Conclusion: The hypothesis that abdominal infectious complications after curative intent surgery for T4 colon cancer is associated with the development of abdominal recurrences was confirmed in this study

Item Type:	Thesis (Thesis)
Supervisor name:	Boer, Dr. M.T. de and Tanis, Dr. P.J.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:45
Last Modified:	25 Jun 2020 10:45
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/688

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