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Perioperative Morbidity Affects Long-Term Survival in Patients Following Liver Resection for Colorectal Metastases

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Hepatic resection is the treatment of choice in patients with colorectal liver metastases. Perioperative morbidity is associated with decreased long-term survival in several cancers. The aim of this study was to assess the impact of perioperative morbidity and other prognostic factors on the outcome of patients undergoing liver resection for colorectal metastases.

Methods

One hundred ninety seven patients undergoing liver resection with curative intent were investigated. The influence of prognostic factors, such as complications, tumor stage, margins, age, sex, number of lesions, transfusion, portal inflow obstruction, and era and type of resection, was assessed using univariate and multivariate analysis. Complications were graded using an objective surgical complication classification.

Results

The 5-year survival rate was 38%, with a median follow up of 4.5 years. The disease-free survival rate at 5 years was 23%. The perioperative morbidity and mortality rates were 30 and 2.5%, respectively. The median survival of patients with perioperative complications was 3.2 years, compared to 4.4 years in those patients without complications (p < 0.01). For patients with positive resection margins, the median survival was 2.1 years, compared 4.4 years in patients with a margin (p = 0.019).

Conclusion

Perioperative morbidity and a positive resection margin had a negative impact on long-term survival in patients following liver resection for colorectal metastases.

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Acknowledgements

We would like to thank Kylie Lange, statistical consultant from Flinders University, for the statistical advice and thorough review of the data and Lisa Leopardi for the assistance in the data management.

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Authors and Affiliations

  1. Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland

    M. Schiesser

  2. Department of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia

    J. W. C. Chen & R. T. A. Padbury

  3. Department of Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia

    G. J. Maddern

  4. Surgical and Specialty Services, Flinders Medical Centre, Bedford Park 5042, South Australia, Australia

    R. T. A. Padbury

Authors
  1. M. Schiesser
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  2. J. W. C. Chen
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  3. G. J. Maddern
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  4. R. T. A. Padbury
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Correspondence to R. T. A. Padbury.

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Schiesser, M., Chen, J.W.C., Maddern, G.J. et al. Perioperative Morbidity Affects Long-Term Survival in Patients Following Liver Resection for Colorectal Metastases. J Gastrointest Surg 12, 1054–1060 (2008). https://doi.org/10.1007/s11605-007-0438-y

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  • DOI: https://doi.org/10.1007/s11605-007-0438-y

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