Long-term Oncologic Outcome of Postoperative Complications After Colorectal Cancer Surgery

Abstract

Purpose: The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.Methods: From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.Results: Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).Conclusion: Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

Does Preoperative Waiting Time Affect the Short-Term Outcomes and Prognosis of Colorectal Cancer Patients? A Retrospective Study from the West of China

“…The prognosis of CRC patients was currently concentrated by surgeons. It was revealed that the OS and DFS of CRC patients were affected by age, underlying diseases, tumor staging, and postoperative complications, which was largely consistent with our conclusions [ 30 , 31 ]. Some previous studies did not find an association between the waiting time and survival [ 11 – 13 ].…”

Surgical safety in the COVID-19 era: present and future considerations

“…Postoperative COVID-19 infection was significantly associated with mortality (adjusted odds ratio, 16.90; P < 0.001), which required surgeons to undertake stringent mitigation measures [ 27 ]. Furthermore, the leakage rate presented in this study was comparable to those of around 10% reported in the pre-pandemic era [ 37 38 ]. In addition, a further study reported a 10-fold increase in mortality among symptomatic COVID-19 patients but only a 2-fold increase in asymptomatic patients after gastrointestinal surgery.…”

Surgical site infection after laparoscopic resection of colorectal cancer is associated with compromised long-term oncological outcome

“…In contrast, Mark et al reported similar oncological results after resection for rectal cancer among patients who had major complications, those who had minor complications and those without complications [ 19 ]. Oh et al reported similar oncological results in patients with major (CD grade III or IV) or minor (grade I or II) complications after colorectal cancer surgery [ 24 ]. In the present study, RFS did not differ between patients who developed major SSI and those who developed minor SSI.…”

“…Previous studies have usually included both patients after open surgery and those after laparoscopic surgery [ 14 , 15 , 19 – 24 , 30 – 32 ]. However, laparoscopic surgery has been applied for the majority of elective resections for colorectal cancer in recent years.…”

“…Infectious complications after surgery have been reported to compromise long-term oncological results in gastric cancer [ 7 – 9 ], esophageal cancer [ 10 ], and breast cancer [ 11 ]. With regard to colorectal cancer, although anastomotic leak (AL) has been suggested as a risk factor for local recurrence [ 12 – 15 ], the impact of infectious complications including surgical site infections (SSIs) such as AL on long-term oncological outcome after resection of colorectal cancer has been controversial [ 12 – 24 ]. In particular, studies limited to patients after laparoscopic colorectal resection remain scarce [ 25 ].…”