Major postoperative complications following elective resection for colorectal cancer decrease long‐term survival but not the time to recurrence. (February 2015)

• Record Type: Journal Article
• Authors: Odermatt, M.; Miskovic, D.; Flashman, K.; Khan, J.; Senapati, A.; O'Leary, D.; Thompson, M.; Parvaiz, A.
• Is Part Of: Colorectal disease. Volume 17:Number 2(2015)
• Page Start: 141
• Page End: 149
• Publication Date: 2015-02
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12757
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12757-abs-0001"> <title>Abstract</title> <sec id="codi12757-sec-0001" sec-type="section"> <title>Aim</title> <p>The aim of the study was to determine the effect of major complications after colorectal cancer surgery on survival and time to recurrence.</p> </sec> <sec id="codi12757-sec-0002" sec-type="section"> <title>Method</title> <p>Patients having a curative colorectal cancer resection and a follow‐up of at least 3 years were identified from a prospective database. Major complications were defined as Clavien–Dindo Grades 3b or 4 and their impact on time to recurrence and mortality was analysed by univariate and multivariable analysis. Postoperative death within 30 days or during the initial hospitalization (Clavien–Dindo Grade 5) was <italic>a priori</italic> excluded.</p> </sec> <sec id="codi12757-sec-0003" sec-type="section"> <title>Results</title> <p>From 2003 to 2012, 868 colorectal cancer resections resulting in 63 (7%) major postoperative complications including deaths (Clavien–Dindo ≥ 3b) were identified. After exclusion of Grade 5 complications (postoperative or in‐hospital deaths), 844 resections with 39 (5%) major complications remained for analysis. Median follow‐up time was 5.7 years. Using the Kaplan–Meier method, the estimated crude 5‐year overall survival probability was 78% (95% CI 75–81) in the group without and 65% (95% CI 51–83) in the group with major complications (<italic>P </italic>=<italic> </italic>0.009, log‐rank test). Major complications were a significant negative predictor for overall survival (hazard ratio 2.42, 95% CI 1.41–4.14) when adjusted for sex, age, American Society of Anesthesiologists grade, tumour site (colon <italic>vs</italic> rectum), R stage and tumour stage. However, in both univariate and multivariable analysis, major complications were not a significant predictor for time to recurrence (hazard ratio 1.29, 95% CI 0.56–2.99).</p> </sec> <sec id="codi12757-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Non‐lethal major postoperative complications seem to have a negative long‐term impact on survival but not on time to recurrence.</p> </sec> </abstract>