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.
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All the authors are with Euregional HPB Collaboration, Aachen-Maastricht, Germany-The Netherlands.
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Lodewick, T.M., de Jong, M.C., van Dam, R.M. et al. Effects of Postoperative Morbidity on Long-Term Outcome Following Surgery for Colorectal Liver Metastases. World J Surg 39, 478–486 (2015). https://doi.org/10.1007/s00268-014-2799-1
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DOI: https://doi.org/10.1007/s00268-014-2799-1