Published in PLOS One on 2026-07-29, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Atalel Fentahun Awedew, Yonatan Abie Tsegaye, Addisu Assfaw Ayen, Fisiha Guade Tesifaw, Bedemariam Tadesse Amsalu, Amsalu Molla Getahun
Source: PLOS One • DOI 10.1371/journal.pone.0354980
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Safe surgery is a fundamental quality indicator within the global surgery framework. Postoperative complications remain a leading global cause of disability, mortality, and economic loss, with a disproportionate impact on low- and middle-income countries (LMICs).
This study aims to generate robust epidemiological data on postoperative outcomes of cancer surgery in Ethiopia.
This study employed a 7-day national observational prospective cohort design. The study enrolled adult patients aged 18 years and older who underwent either elective or non-elective cancer surgery in hospitals across Ethiopia. Statistical analysis included descriptive statistics, chi-square tests for categorical variables, and logistic regression models to identify risk factors for postoperative complications. Outcome measures 7th day postoperative mortality and complications. Statistical significance was set at p < 0.05.
A total of 265 cancer surgeries were performed across 46 hospitals (overall surgeries = 4412). The mean patient age was 46.6 years (SD = 14.9). The majority of patients were classified as low-risk America Society of Anesthesiologists (ASA) physical status classification: ASA I (106/265, 40%) and ASA II (133/265, 50.2%) and low Eastern Cooperative Oncology Group (ECOG) performance status: ECOG 0 (112/265, 42.3%) and ECOG 1 (98/265, 37%). Colorectal cancer surgery was the most common type (38/265, 14.5%), while laparoscopic surgery was performed in only 3/265 cases (1.1%). Postoperative complications developed in 84 of 265 patients (31.7%) with leading complication was superficial surgical site infection 47/265(17.8%). Emergency surgery (AOR = 3.1, 95% CI: 1.1–8.4, p = 0.003), comorbidity (AOR = 2.0, 95% CI: 1.1–3.7, p = 0.025), and an ECOG performance status of III (AOR = 9.5, 95% CI: 1.5–61.1, p = 0.02) were statistically significantly associated with 7th day postoperative complications. The overall 7-day mortality rate after cancer surgery was 5/265 (1.9%).
Despite the relatively young age of patients, their low ASA physical status scores, and good ECOG performance, a significant proportion experienced adverse outcomes following cancer surgery: one in three patients developed postoperative complications, one in nine required reoperations, and one in 53 died. These findings suggest a critical need for evidence-based interventions to strengthen the underlying infrastructure and care processes within the surgical system which are essential to achieving safe, effective, and high-quality surgical care for cancer patients in Ethiopia.
Introduction
Cancer remains a substantial global health challenge, contributing significantly to mortality, morbidity, and disability worldwide [1–3]. Cancer ranks as the second leading cause of global deaths and disability worldwide, with the burden falling disproportionately on low- and middle-income countries (LMICs), including Ethiopia, whose healthcare systems often face considerable resource constraints [1–3].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Atalel Fentahun Awedew, Yonatan Abie Tsegaye, Addisu Assfaw Ayen, Fisiha Guade Tesifaw, Bedemariam Tadesse Amsalu, Amsalu Molla Getahun. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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