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Effects of Postoperative Morbidity on Long-Term Outcome Following Surgery for Colorectal Liver Metastases

World Journal of Surgery volume 39, pages 478–486 (2015)Cite this article

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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Author information

Affiliations

  1. Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    T. M. Lodewick, M. C. de Jong, R. M. van Dam, M. H. A. Bemelmans, S. W. M. Olde Damink & C. H. C. Dejong

  2. Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands

    T. M. Lodewick, M. C. de Jong, R. M. van Dam, M. H. A. Bemelmans, S. W. M. Olde Damink & C. H. C. Dejong

  3. Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany

    T. M. Lodewick & U. P. Neumann

  4. Department of HPB Surgery and Liver Transplantation, Royal Free Hospital- University College London, London, UK

    S. W. M. Olde Damink

Authors
  1. T. M. Lodewick
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  2. M. C. de Jong
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  3. R. M. van Dam
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  4. M. H. A. Bemelmans
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  5. U. P. Neumann
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  6. S. W. M. Olde Damink
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  7. C. H. C. Dejong
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Corresponding author

Correspondence to T. M. Lodewick.

Additional information

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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Keywords

  • Overall Survival
  • Liver Resection
  • Postoperative Morbidity
  • Colorectal Liver Metastasis
  • Clavien Grade