Impact of Postoperative Complications on the Long-Term Outcome of Colorectal Cancer Patients who Underwent Curative Resection

Jen-Hsien Huang, Chun-Chi Lin, Hung-Hsin Lin, Yuan-Tsiu Lan, Shin-Ching Chang, Huann-Sheng Wang, Wei-Shone Chen, Tzu-Chen Lin, Shung-Haur Yang, Jen-Kou Lin and Jeng-Kai Jiang

Department of Colon and Rectal Surgery, Taipei Veterans General Hospital, Taiwan
Department of Surgery, School of Medicine, National Yang-Ming University, Taiwan

^*Correspondance to: Jeng-Kai Jiang 

 PDF  Full Text DOI: 10.25107/2474-1647.2020

Abstract

Aim: The study evaluated the impact of postoperative complications on long-term outcomes in patients after curative resection for Colorectal Cancer (CRC).Methods: Patients undergoing curative resection for CRC from January 1993 to December 2009 were identified from a prospectively maintained database. Postoperative complications were graded through Clavien-Dindo classification, and the patients were divided into minor (grade 1 and grade 2) and major (grade 3 and grade 4) complication groups. Factors potentially affecting disease-free survival (DFS) and overall survival (OS) were examined using univariate and multivariate analyses.Results: A total of 3 666 patients (2 375 men, 64.8%) were included. Complications developed in 823 patients (22.4%), of which 313 (8.5%) were major and 510 (13.9%) were minor complications. The 5-year OS rates for those with major, minor, and no complications were 69.3%, 79.4%, and 86.1% (P<0.001), respectively, whereas the 5-year DFS rates were 62.9%, 71.1%, and 79.7 % (P<0.001), respectively. Major complications were negative predictors of both OS (stage II: hazard ratio [HR]=2.174, 95% confidence interval [CI]: 1.510-3.129, P<0.001; stage III: HR=2.026, 95% CI: 1.482–2.771, P<0.001) and DFS (stage II: HR=1.499, 95% CI: 1.165-1.928, P=0.002; stage III: HR=1.515, 95% CI: 1.226-1.872, P<0.001) in stage II and III patients.Conclusion: Postoperative complications adversely affect the long-term outcomes of CRC patients after curative resection. The impact of major complications was particularly strong in stage II and III patients.

Keywords

Colorectal; Postoperative complication; Recurrence; Survival

Cite the article

Huang J-H, Lin C-C, Lin H-H, Lan Y-T, Chang S-C, Wang H-S, et al. Impact of Postoperative Complications on the Long-Term Outcome of Colorectal Cancer Patients who Underwent Curative Resection. Clin Surg. 2018; 3: 2020.