The impact of major postoperative complications on long-term outcomes following curative resection of colon cancer

Cienfuegos, Javier A.; Baixauli, Jorge; Beorlegui, Carmen; Ortega, Patricia Martínez; Granero, Luzete Cristina Silva; Zozaya, Gabriel; Lizoáin, José Luis Hernández

doi:10.1016/j.ijsu.2018.03.001

Cited by 24 publications

(20 citation statements)

References 31 publications

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“…To our knowledge, there is no literature regarding residual tumour classification as a risk factor for recurrence in colon cancer, although it has been related to poor outcomes (Quintana et al, 2016; Yabusaki, Nashimoto, Matsuki, & Aizawa, 2014). Third, ASA grade, a variable related to surgical risk, is a controversial variable regarding the prognosis of recurrence (Cienfuegos et al, 2018;Mörner et al, 2017), but in accordance with some previous findings (Cienfuegos et al, 2018), we found that patients classified as ASA IV were 2-3 times as likely to have early recurrence. Finally, having infectious complications during the first year after surgery plays an important role in early recurrence.…”

Section: Ta B L E 2 (Continued)supporting

confidence: 91%

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

et al. 2020

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Section: Ta B L E 2 (Continued)supporting

confidence: 91%

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

et al. 2020

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“…Recent studies have shown that postoperative complications have a negative effect on the oncologic outcome. In particular, infectious complications, surgical intensive care unit admission, and location of anastomosis leakage were associated with negative prognosis [ 7 , 11 , 12 , 23 , 27 - 29 ]. Several studies demonstrated that postoperative complications impact short-term and long-term survival as described above.…”

Section: Discussionmentioning

confidence: 99%

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

Huh

Lee

et al. 2020

Ann Coloproctol

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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.

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“…After excluding CDC grade V, they found major POCs (IIIb or IV) were significantly associated with OS. Cienfuegos et al 21 examined major POCs (≥CDC grade IIIb) in 950 patients with resected stage I–III colon cancer and identified 51 (5%) cases experienced major POCs. They also found major POCs were associated with long-term OS and disease-free survival (DFS), especially in stage III cancers.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have revealed that major POCs evaluated by CDC adversely affect long-term outcomes of CRC patients after resection. 20,21 However, CDC defines the severity of the complication in a single patient according to the most serious complication, and CDC grade alone cannot effectively reflect multiple complications.…”

Section: Introductionmentioning

confidence: 99%

<p>Associations of Postoperative Complications Assessed by Clavien–Dindo Classification and Comprehensive Complication Index with Long-Term Overall Survival in Elderly Patients after Radical CRC Resection</p>

Wang¹,

Zhang²,

Bai³

et al. 2020

CIA

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Background: Advancing age is associated with high incidence of colorectal cancer (CRC) and high rates of postoperative complications (POCs). However, the impact of of POC severity-evaluated by Clavien-Dindo classification (CDC) or comprehensive complication index (CCI)-on long-term overall survival (OS) in elderly patients after radical CRC resection is not clear. Methods: Elderly patients aged 65 years or more with CRC undergoing radical resection were retrospectively recruited. POC details were collected and evaluated using CDC grades and the CCI, blinded to patients' other information. Risk factors for CDC grade ≥II POCs were analyzed by multivariate logistic regression. Effects of CDC grade II-IV POCs on long-term OS were analyzed via propensity-score matching (PSM) analysis followed by Kaplan-Meier curve plotting and multivariate Cox proportional-hazard regression adjusted for all potential confounders. The prognostic value of the CCI was also explored and compared with CDC grades. Results: A total of 614 elderly patients were identified, of which 20, 106, 25, 11, and 13 cases experienced CDC grade I, II, III, IV, and V POCs, respectively. Higher age, female sex, coronary heart diseases, family history of tumors, preoperative anemia, high amount of bleeding during operation, and high positive dissected lymph-node ratio were found to be risk factors for CDC grade II-V POCs. After PSM analyses, CDC grade II-IV POCs were identified to be associated with poor long-term OS, which was also verified in the entire cohort. The CCI was also found to be significantly associated with decreased long-term OS and showed prognostic values similar to CDC grades. Conclusion: Both CDC grades and the CCI can be used to evaluate POCs and are associated with long-term OS in elderly patients undergoing radical CRC resection.

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The impact of major postoperative complications on long-term outcomes following curative resection of colon cancer

Abstract: The development of major complications following colectomy for colon cancer has a negative impact on long-term oncologic outcomes, especially in stage III disease.

Cited by 24 publications

References 31 publications

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

Factors associated with colon cancer early, intermediate and late recurrence after surgery for stage I–III: A 5‐year prospective study

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

<p>Associations of Postoperative Complications Assessed by Clavien–Dindo Classification and Comprehensive Complication Index with Long-Term Overall Survival in Elderly Patients after Radical CRC Resection</p>

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