Table 3.

Adjusted rate ratios^* for late, major surgical intervention by organ system and based on treatment exposures within 5 years of cancer diagnosis

Central Nervous System Treatment Exposures	Rate Ratio (95% CI) of Late Central Nervous System Surgery
No CNS surgery, no cranial RT	1.0 (reference)
+ CNS surgery, no cranial RT	20.3 (15.3 – 26.8)
No CNS surgery, + cranial RT	6.2 (4.7 – 8.3)
+ CNS surgery + cranial RT	21.9 (17.0 – 28.2)
Cardiovascular/Respiratory Treatment Exposures	Late Cardiovascular Surgery
No CV/Resp Surg, no chest RT	1.0 (reference)
+ CV/Resp Surg, no chest RT	1.2 (1.0 – 1.6)
No CV/Resp Surg, + chest RT	2.1 (1.8 – 2.3)
+ CV/Resp Surg + chest RT	2.5 (2.0 – 3.1)
Cardiovascular/Respiratory Treatment Exposures	Late Respiratory Surgery
No CV/Resp Surg, no chest RT	1.0 (reference)
+ CV/Resp Surg, no chest RT	5.3 (3.9–7.4)
No CV/Resp Surg, + chest RT	1.6 (1.1–2.1)
+ CV/Resp Surg + chest RT	4.6 (3.1–6.6)
Gastrointestinal Treatment Exposures	Late Gastrointestinal Surgery
No GI Surg, no abd/pelvis RT	1.0 (reference)
+ GI Surg, no abd/pelvis RT	1.7 (1.4–1.9)
No GI Surg, + abd/pelvis RT	1.3 (1.1–1.5)
+ GI Surg + abd/pelvis RT	1.9 (1.7–2.1)
Musculoskeletal Treatment Exposures	Late Musculoskeletal Surgery
No MSK surgery, no RT	1.0 (reference)
+ MSK surgery, no RT	3.2 (2.8–3.6)
+ RT, no MSK surgery	1.0 (0.9–1.1)
+ MSK surgery, + RT	2.7 (2.4–3.2)

^*Adjusted for attained age as cubic splines, sex, race/ethnicity, and health insurance status. CNS – central nervous system, CV – cardiovascular, Resp – respiratory, GI – gastrointestinal, MSK – musculoskeletal, RT – radiotherapy.

Respiratory surgeries comprise non-cardiac thoracic operations on the lung and airway.