Oncological outcome of surgical site infection after colorectal cancer surgery

Int J Colorectal Dis. 2019 Feb;34(2):277-283. doi: 10.1007/s00384-018-3194-4. Epub 2018 Nov 13.

Abstract

Background: This study evaluated the oncological outcome of surgical site infection (SSI) after colorectal cancer surgery.

Methods: A total of 3675 consecutive patients with colorectal cancer who underwent curative resection from January 2009 to December 2011 were analyzed. The prognostic significance of SSI was evaluated. Risk factors for SSI were also identified using multivariate regression analysis.

Results: Overall SSI rate was 9.6%, in which 5.5% was superficial or deep SSI and 4.1% was organ/space SSI. Incidence of SSI varied significantly with tumor location (P < 0.001): 7.1% in colon cancer and 14.0% in rectal cancer. With a median follow-up period of 49.8 months, the 5-year disease-free survival rates of patients without and with SSI were 87% and 83%, respectively (P = 0.018). SSI predicted disease-free survival in univariate analysis. However, SSI was not an independent predictor of survival in multivariate analysis. Body mass index, ASA score, preoperative WBC count, rectal tumor, open surgery, operation time, and transfusion during surgery were independent predictors of SSI.

Conclusion: SSI predicted disease-free survival in colorectal cancer patients following curative surgery. Patient' demographics, tumor characteristics, and perioperative conditions were independently associated with an increased likelihood of SSI.

Keywords: Colorectal cancer; Surgical site infection; Survival.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / adverse effects*
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Surgical Wound Infection / etiology*
  • Treatment Outcome
  • Young Adult