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

Odermatt, Manfred; Mišković, Danilo; Flashman, Karen; Khan, Jim; Senapati, Asha; O’Leary, D; Thompson, Michael D.; Parvaiz, Amjad

doi:10.1111/codi.12757

Cited by 48 publications

(43 citation statements)

References 37 publications

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“…We observed a tendency for these indices to over-predict the expected mortality and morbidity as compared to that actually observed (29). Postoperative morbidity was higher in the right hemicolectomies, which is in agreement with the data from several studies (30). This has been linked to older age, the need for blood products during surgery and a greater number of open surgeries at this location (30,31).…”

Section: Discussionsupporting

confidence: 90%

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

et al. 2017

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Section: Discussionsupporting

confidence: 90%

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

et al. 2017

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“…Selected papers, published between 2011 and 2016, are summarized in Table 3, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55. These studies were cohort studies that conducted risk adjustment using multivariate analysis.…”

Section: Resultsmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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“…They concluded that employing fast track therapy in the treatment of older patients was not only feasible, but might also reduce the number of general complications and the duration of hospital stay. Moreover, there are several studies showing that postoperative complication could decrease survival [1920]. Carefully considering from these results, movements to accelerate recovery after surgery could be a factor that might affect survival.…”

Section: Discussionmentioning

confidence: 99%

Differences in the survival rates of older patients with colorectal cancers in 2003 and 2009

et al. 2017

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PurposeThe aim of this study was to investigate survival in patients aged ≥70 years who underwent colorectal cancer surgery in 2003 and 2009. In addition, we aimed to identify the factors that could affect survival in these patients.MethodsIn a cross-sectional study, a retrospective review of the data for 878 patients who underwent colorectal cancer surgery with curative intent in the years 2003 and 2009 was performed. The primary outcome was the 5-year overall survival rate (5-OSR), and the clinicopathologic factors that could affect overall survival were analyzed.ResultsThe 5-OSR was 77.8% and 84.9% in 2003 and 2009, respectively (P = 0.013). Age, American Society of Anesthesiologists physical status classification, stage, type of surgery, and length of hospital stay possibly affected survival per the univariate and multivariate analyses. In patients aged ≥70 years, the 5-OSR in 2009 was 75.9%, which showed improvement compared to 53.7% in 2003 (P = 0.027). The stage, type of surgery, and hospital stay were the variables that possibly affected survival in patients aged ≥70 years per the univariate analysis, whereas the stage (III; hazard ratio [HR], 2.188; P = 0.005) and length of hospital stay (>12 days; HR, 2.307; P = 0.004), were the variables that showed statistical significance on the multivariate analysis.ConclusionWe found that early stage and shortening the length of hospital stay could affect survival in older patients with colorectal cancers. Because of limited evidence on the influence of shortening the length of hospital stay on survival in older patients, further investigations are warranted.

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

Abstract: Non-lethal major postoperative complications seem to have a negative long-term impact on survival but not on time to recurrence.

Cited by 48 publications

References 37 publications

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Differences in the survival rates of older patients with colorectal cancers in 2003 and 2009

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