Does liver cirrhosis affect the surgical outcome of primary colorectal cancer surgery? A meta-analysis

Abstract

Purpose The purpose of this meta-analysis was to evaluate the effect of liver cirrhosis (LC) on the short-term and long-term surgical outcomes of colorectal cancer (CRC). Methods The PubMed, Embase, and Cochrane Library databases were searched from inception to March 23, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of enrolled studies, and RevMan 5.3 was used for data analysis in this meta-analysis. The registration ID of this current meta-analysis on PROSPERO is CRD42021238042. Results In total, five studies with 2485 patients were included in this meta-analysis. For the baseline information, no significant differences in age, sex, tumor location, or tumor T staging were noted. Regarding short-term outcomes, the cirrhotic group had more major complications (OR=5.15, 95% CI=1.62 to 16.37, p=0.005), a higher re-operation rate (OR=2.04, 95% CI=1.07 to 3.88, p=0.03), and a higher short-term mortality rate (OR=2.85, 95% CI=1.93 to 4.20, p<0.00001) than the non-cirrhotic group. However, no significant differences in minor complications (OR=1.54, 95% CI=0.78 to 3.02, p=0.21) or the rate of intensive care unit (ICU) admission (OR=0.76, 95% CI=0.10 to 5.99, p=0.80) were noted between the two groups. Moreover, the non-cirrhotic group exhibited a longer survival time than the cirrhotic group (HR=2.96, 95% CI=2.28 to 3.85, p<0.00001). Conclusion Preexisting LC was associated with an increased postoperative major complication rate, a higher rate of re-operation, a higher short-term mortality rate, and poor overall survival following CRC surgery.

Gastrointestinal Cancers and Liver Cirrhosis: Implications on Treatments and Prognosis

“…A cohort study from Danish population showed that the 30-day postoperative mortality was 24.1% in patients with cirrhosis and only 8.7% in patients without cirrhosis, indicating a significant increase in postoperative mortality ( 71 ). This is consistent with the results of other studies ( 72 – 76 ). Han et al.…”

“…A cohort study from Danish population showed that the 30-day postoperative mortality was 24.1% in patients with cirrhosis and only 8.7% in patients without cirrhosis, indicating a significant increase in postoperative mortality (71). This is consistent with the results of other studies (72)(73)(74)(75)(76). Han et al demonstrated that CRC patients with cirrhosis had a higher rate of intraoperative blood loss, higher likelihood of postoperative complications, and longer hospital stay (75).…”

The Effect of Type 2 Diabetes Mellitus on the Short-Term Outcomes and Prognosis of Stage I–III Colorectal Cancer: A Propensity Score Matching Analysis

“…2 In addition, the number of CRC patients is expected to increase in the future, 3 and surgery is still the main treatment for CRC. 4,5 Type 2 diabetes mellitus (T2DM) causes a significant burden on patients and society globally, 6 and T2DM accounts for increased morbidity and mortality. 7 The number of T2DM patients is expected to reach 700 million in 2045.…”

The Effect of the Intraoperative Blood Loss and Intraoperative Blood Transfusion on the Short-Term Outcomes and Prognosis of Colorectal Cancer: A Propensity Score Matching Analysis

“…However, an upward trend has been existing in China; moreover, China is a country with the largest number of new cases and deaths of CRC every year in the world ( 2 ). At present, radical surgical treatment of CRC is still the most important and decisive treatment ( 3 – 5 ).…”