Effects of postoperative morbidity on long-term outcome following surgery for colorectal liver metastases

T.M. Lodewick, M.C. de Jong, R.M. van Dam, M.H. Bemelmans, U. P. Neumann, S.W. Olde Damink, C.H. Dejong

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.
Original languageEnglish
Pages (from-to)478-486
Number of pages9
JournalWorld Journal of Surgery
Volume39
Issue number2
DOIs
Publication statusPublished - Feb 2015

Keywords

  • HEPATIC RESECTION
  • CURATIVE RESECTION
  • EXPANDING CRITERIA
  • NATURAL HISTORY
  • CANCER-PATIENTS
  • SURVIVAL
  • COMPLICATIONS
  • IMPACT
  • RESECTABILITY
  • HEPATECTOMY

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