BACKGROUND: The impact of postoperative complications on long-term outcomes after surgery for colorectal liver metastases (CRLM) remains controversial. During the last decade, advances in surgical as well as non-surgical treatment have increased resectability and altered outcomes. We sought to determine the influence of postoperative morbidity on disease-free (DFS) and overall survival (OS). METHODS: All patients undergoing liver resection for CRLM for the first time between 2000 and 2011 were retrospectively identified from a prospective database. Postoperative morbidity was classified according to Dindo-Clavien grade. A Dindo-Clavien grade >/=3a was considered a major complication. Primary outcomes were DFS and OS depending on the presence or absence of postoperative morbidity. RESULTS: Of the 266 included patients, 97 patients (37 %) developed postoperative complications, of whom 61 (23 %) had major complications. Median DFS and OS (5-year) were 17 and 53 months (42 %). The occurrence of postoperative morbidity did not significantly shorten OS (p = 0.130) and DFS (p = 0.101). However, major morbidity reduced DFS significantly (p < 0.05). CONCLUSION: In the present study, the occurrence of major postoperative complications was associated with diminished DFS. However, the effect of (major) complications on OS did not reach statistical significance.
- HEPATIC RESECTION
- CURATIVE RESECTION
- EXPANDING CRITERIA
- NATURAL HISTORY
Lodewick, T. M., de Jong, M. C., van Dam, R. M., Bemelmans, M. H., Neumann, U. P., Olde Damink, S. W., & Dejong, C. H. (2015). Effects of postoperative morbidity on long-term outcome following surgery for colorectal liver metastases. World Journal of Surgery, 39(2), 478-486. https://doi.org/10.1007/s00268-014-2799-1