Postoperative Complications have Minimal Impact on Long-Term Prognosis in Immunodeficient Patients with Esophageal Cancer.

ABSTRACT

BACKGROUND: Postoperative complications have been recognized to have an adverse prognostic impact in various types of cancer. However, in a recent study, it has been reported that postoperative complications of total gastrectomy with splenectomy have little impact on the long-term outcomes of patients with gastric cancer. In addition, the mechanisms underlying the effect of postoperative complications on outcomes remain to be elucidated. We hypothesized that immunosuppression by postoperative complications may affect long-term outcomes in patients with esophageal cancer. METHODS: In this retrospective study, we assessed in 153 patients with esophageal cancer who underwent curative subtotal esophagectomy at our hospital and examined the correlation between postoperative complications, and multiple clinicopathological factors, and long-term outcomes with the patients stratified by total lymphocyte count (TLC). RESULTS: The median preoperative TLC was 1432. A total of 115 patients (75.2%) had a TLC of ≥ 1000/µL (high TLC group), and the remaining 38 patients (24.8%) had a TLC of < 1000/µL (low TLC group). Postoperative complications occurred in 39 of 153 cases (25.5%). There was no significant correlation between postoperative complications and any of the clinicopathological factors in either group. In the high TLC group, patients with postoperative complications had significantly lower overall and disease-free survival rates compared with those without complications (p < 0.001 and p < 0.01, respectively). In the low TLC group, no survival difference between patients with and without postoperative complications was observed. CONCLUSIONS: Postoperative complications may have a minimal impact on long-term outcomes in immunodeficient patients.