Key result
Severe postoperative complications (Clavien-Dindo grade ≥ 3) after curative colorectal cancer resection were associated with a higher risk of relapse or death (HR 2.08; 95% CI 1.3-3.3; P=0.018).
Why the study?
Are postoperative complications associated with worse relapse-free survival in patients undergoing curative resection for stage I to III colorectal cancer?
Cohort (n=673)
Are postoperative complications associated with worse relapse-free survival in patients undergoing curative resection for stage I to III colorectal cancer?
Severe postoperative complications (CD grade ≥ 3) are associated with significantly worse long-term relapse-free survival in patients with stage I to III colorectal cancer.
Patients with major complications after CRC resection may need intensified surveillance; leaves open whether prevention improves survival.
OBJECTIVE: We retrospectively evaluated the impact of postoperative complications on long-term outcomes after curative resection for colorectal cancer (CRC), using propensity-score analysis (PSA). PATIENTS AND METHODS: We reviewed data from 673 consecutive patients with stage I to III CRC, who underwent curative resections between 2005 and 2017. Patients were divided into the complication group (Clavien-Dindo [CD] grade ≥ 3) and the control group (others). We performed PSA to obtain unbiased estimates of the effects of the oncological background on each outcome. RESULTS: We matched for sex, age, American Society of Anesthesiologists grade, location (right colon/left colon/rectum), histology (tub1/tub2/por), pathological tumor depth, and lymph node metastases. Eighty-five patients (12.6%) developed postoperative complications with CD grade ≥ 3. After PSA, 81 patients were included in each group. The complication group showed significantly worse relapse-free survival (RFS) than the control group (5-year RFS rate: 62% vs 77%; P = .047). In multivariate analysis with inverse probability of treatment weights, the complication group had a higher risk of relapse or death than the control group (hazard ratio: 2.08, 95% confidence interval:1.3-3.3; P = .018). CONCLUSIONS: Postoperative complications (CD grade ≥ 3) could cause poor long-term outcomes in patients with stage I to III CRC; their presence requires appropriate adjuvant chemotherapy and follow-up.
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Miyamoto et al. (2020) conducted a cohort in Stage I to III colorectal cancer (n=673). Postoperative complications (Clavien-Dindo grade ≥ 3) vs. Control group (other or no complications) was evaluated on Relapse-free survival (HR 2.08, 95% CI 1.3-3.3, p=.018). Severe postoperative complications (Clavien-Dindo grade ≥ 3) after curative colorectal cancer resection were associated with a higher risk of relapse or death (HR 2.08; 95% CI 1.3-3.3; P=0.018).
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