Prognostic significance of postoperative complication after curative resection for patients with gastric cancer

To investigate the impact of postoperative complication on long-term survival in gastric cancer patients after curative resection.A total 663 gastric cancer patients undergoing potentially curative resection during January 2010 to November 2014 were studied. Complications were classified according to the Clavien-Dindo severity classification.Postoperative complications occurred in 138 of 663 cases (20.8%). Multivariate analysis identified >65 years old (P = 0.001), male (P = 0.035), and total gastrectomy (P = 0.037) as independent risk factors for postoperative complications. The 5-year overall survival rate was 48.7% in the no complication group, which was significantly better than that in the complication group (42.7%, P = 0.01). Further stratified analysis by cancer staging revealed that decline in 5-year overall survival due to postoperative complication existed among stage I (P = 0.032), II (P = 0.041), and III (P = 0.001) patients. Cox proportional hazards model showed that increasing pT (P = 0.013) and pN (P = 0.001) grade, advanced pTNM (P = 0.001) stage, total gastrectomy (P = 0.001), and postoperative complication (P = 0.006) were independent prognostic factors.Postoperative complications have a significant negative impact on the long-term survival in gastric cancer patients even if the tumor is resected curatively.