Associations between blood cultures after surgery for colorectal cancer and long-term oncological outcomes

Sara Kehlet Watt, Tina Fransgaard, Thea Helene Degett, Lau Caspar Thygesen, Thomas Benfield, J D Knudsen, Kurt Fuursted, Thøger Gorm Jensen, Ram Dessau, Henrik Carl Schønheyder, Jens Kjølseth Møller, Ismail Gögenur

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Abstract

Background: Systemic inflammation following curative surgery for colorectal cancer may be associated with increased risk of recurrence. [Correction added on 29 November 2019, after first online publication: text amended for accuracy.] This study investigated whether a clinically suspected infection, for which blood cultures were sent within 30 days after surgery for colorectal cancer, was associated with long-term oncological outcomes. Methods: This register-based national cohort study included all Danish residents undergoing surgery with curative intent for colorectal cancer between January 2003 and December 2013. Patients who developed recurrence or died within 180 days after surgery were not included. Associations between blood cultures taken within 30 days after primary surgery and overall survival, disease-free survival and recurrence-free survival were analysed using Cox regression models adjusted for relevant clinical confounders, including demographic data, cancer stage, co-morbidity, blood transfusion, postoperative complications and adjuvant chemotherapy. Results: The study included 21 349 patients, of whom 3390 (15·9 per cent) had blood cultures taken within 30 days after surgery. Median follow-up was 5·6 years. Patients who had blood cultures taken had an increased risk of all-cause mortality (hazard ratio (HR) 1·27, 95 per cent c.i. 1·20 to 1·35; P < 0·001), poorer disease-free survival (HR 1·22, 1·16 to 1·29; P < 0·001) and higher risk of recurrence (HR 1·15, 1·07 to 1·23; P < 0·001) than patients who did not have blood cultures taken. Conclusion: A clinically suspected infection requiring blood cultures within 30 days of surgery for colorectal cancer was associated with poorer oncological outcomes.

Original languageEnglish
JournalBritish Journal of Surgery
Volume107
Issue number3
Pages (from-to)310-315
ISSN0007-1323
DOIs
Publication statusPublished - Feb 2020

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