Incidence and risk factors of postoperative pneumonia following cancer surgery in adult patients with selected solid cancer: results of “Cancer POP” study

Jiwon Jung, Song Mi Moon, Hee Chang Jang, Cheol In Kang, Jae Bum Jun, Yong Kyun Cho, Seung Ji Kang, Bo Jeong Seo, Young Joo Kim, Seong Beom Park, Juneyoung Lee, Chang Sik Yu, Sung Han Kim

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Abstract

The aim of this study was to investigate the incidence and risk factors of postoperative pneumonia (POP) within 1 year after cancer surgery in patients with the five most common cancers (gastric, colorectal, lung, breast cancer, and hepatocellular carcinoma [HCC]) in South Korea. This was a multicenter and retrospective cohort study performed at five nationwide cancer centers. The number of cancer patients in each center was allocated by the proportion of cancer surgery. Adult patients were randomly selected according to the allocated number, among those who underwent cancer surgery from January to December 2014 within 6 months after diagnosis of cancer. One-year cumulative incidence of POP was estimated using Kaplan–Meier analysis. An univariable Cox's proportional hazard regression analysis was performed to identify risk factors for POP development. As a multivariable analysis, confounders were adjusted using multiple Cox's PH regression model. Among the total 2000 patients, the numbers of patients with gastric cancer, colorectal cancer, lung cancer, breast cancer, and HCC were 497 (25%), 525 (26%), 277 (14%), 552 (28%), and 149 (7%), respectively. Overall, the 1-year cumulative incidence of POP was 2.0% (95% CI, 1.4–2.6). The 1-year cumulative incidences in each cancer were as follows: lung 8.0%, gastric 1.8%, colorectal 1.0%, HCC 0.7%, and breast 0.4%. In multivariable analysis, older age, higher Charlson comorbidity index (CCI) score, ulcer disease, history of pneumonia, and smoking were related with POP development. In conclusions, the 1-year cumulative incidence of POP in the five most common cancers was 2%. Older age, higher CCI scores, smoker, ulcer disease, and previous pneumonia history increased the risk of POP development in cancer patients.

Original languageEnglish
Pages (from-to)261-269
Number of pages9
JournalCancer Medicine
Volume7
Issue number1
DOIs
Publication statusPublished - 2018 Jan 1

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Keywords

  • Breast cancer
  • colorectal cancer
  • gastric cancer
  • hepatocellular carcinoma
  • lung cancer
  • postoperative pneumonia

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Jung, J., Moon, S. M., Jang, H. C., Kang, C. I., Jun, J. B., Cho, Y. K., Kang, S. J., Seo, B. J., Kim, Y. J., Park, S. B., Lee, J., Yu, C. S., & Kim, S. H. (2018). Incidence and risk factors of postoperative pneumonia following cancer surgery in adult patients with selected solid cancer: results of “Cancer POP” study. Cancer Medicine, 7(1), 261-269. https://doi.org/10.1002/cam4.1259