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Association Between the Most Frequent Complications After Surgery for Stage I–III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to identify the ten most frequent complications after surgery for stage I–III colon cancer and to assess the association between these complications and overall survival, conditional overall survival, and recurrences.

Methods

All patients who underwent surgery for stage I–III colon cancer in five hospitals in the Western region of the Netherlands were identified. Crude and adjusted Cox proportional hazards models were used to study the association between complications and 1-year overall survival, 5-year overall survival, 5-year conditional overall survival, and 5-year disease-free period.

Results

Data from 761 patients were used for the analyses. Complications were associated with decreased 1-year overall survival (hazard ratio (HR) 2.87, 95 % confidence interval (CI) 1.82–4.51; p < 0.001), 5-year overall survival (HR 1.59, 95 % CI 1.25–2.04; p < 0.001), and 5-year conditional overall survival (HR 1.34, 95 % CI 1.06–1.69; p = 0.016), whereas an increasing number of complications had no additional impact. Anastomotic leakage, excessive blood loss, and (abdominal) sepsis were associated with reduced 1-year overall survival, anastomotic leakage, delirium, abscess, and (abdominal) sepsis with reduced 5-year overall survival, and anastomotic leakage, delirium, and abscess with reduced 5-year conditional overall survival. Anastomotic leakage, electrolyte disorders, and abscess were risk factors for recurrence within five years.

Conclusions

Our results demonstrate the serious impact of the most frequent complications after surgery for colon cancer on short-term and long-term outcomes. This study confirms the prolonged impact of surgery and demonstrates that complications result not only in reduced 1-year survival, but also in reduced long-term outcomes.

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Acknowledgments

The authors thank the registration team of the Netherlands Comprehensive Cancer Organisation (IKNL), location Leiden, and H. D. M. Murk Jansen for the collection of data.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands

    A. J. Breugom MD, D. T. van Dongen MD, E. Bastiaannet PhD, G. J. Liefers MD, PhD, W. E. Mesker PhD & C. J. H. van de Velde MD, PhD

  2. Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands

    E. Bastiaannet PhD

  3. Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands

    F. W. Dekker PhD

  4. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands

    L. G. M. van der Geest MSc

  5. Department of Surgery, Medical Centre Haaglanden, The Hague, The Netherlands

    A. W. K. S. Marinelli MD, PhD

  6. Department of Internal Medicine, HAGA Hospital, The Hague, The Netherlands

    J. E. A. Portielje MD, PhD

  7. Department of Surgery, HAGA Hospital, The Hague, The Netherlands

    W. H. Steup MD, PhD

  8. Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands

    L. N. L. Tseng MD

  9. Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands

    J. W. T. Dekker MD, PhD

Authors
  1. A. J. Breugom MD
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  2. D. T. van Dongen MD
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  3. E. Bastiaannet PhD
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  4. F. W. Dekker PhD
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  5. L. G. M. van der Geest MSc
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  6. G. J. Liefers MD, PhD
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  7. A. W. K. S. Marinelli MD, PhD
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  8. W. E. Mesker PhD
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  9. J. E. A. Portielje MD, PhD
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  10. W. H. Steup MD, PhD
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  11. L. N. L. Tseng MD
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  12. C. J. H. van de Velde MD, PhD
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  13. J. W. T. Dekker MD, PhD
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Corresponding author

Correspondence to A. J. Breugom MD.

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Breugom, A.J., van Dongen, D.T., Bastiaannet, E. et al. Association Between the Most Frequent Complications After Surgery for Stage I–III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences. Ann Surg Oncol 23, 2858–2865 (2016). https://doi.org/10.1245/s10434-016-5226-z

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  • DOI: https://doi.org/10.1245/s10434-016-5226-z

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