Impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer: A multicenter retrospective cohort study

Fujita, Yusuke; Hida, Koya; Hoshino, Nobuaki; Sakai, Yoshiharu; Konishi, Tsuyoshi; Kanazawa, Akiyoshi; Goto, Michitoshi; Saito, Shuji; Suda, Tadashi; Watanabe, Masahiko

doi:10.1002/ags3.12433

Cited by 9 publications

(7 citation statements)

References 30 publications

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“…After CRC surgery, the incidence of complications was 18%-38% (6)(7)(8)(20)(21)(22). Complications could increase hospital stay and costs (9), furthermore, patients' mental stress would increase, and some complications might be life-threatening.…”

Section: Discussionmentioning

confidence: 99%

“…In the current study, we found that age, tumor stage and complications were independent factors of OS and DFS as well. The mechanism of complications which worsened the prognosis might be as follows: 1, complications might delay the follow-up chemotherapy of CRC patients, thus affecting OS and DFS (28,29); 2, complications directly caused damage to the patients' organs and inhibition of the adaptive immune response, resulting in malfunction, thus affecting OS and DFS (8,30); and 3, postoperative peritoneal infection enhanced the invasive activity of residual tumor cells after CRC surgery (31).…”

Section: Discussionmentioning

confidence: 99%

“…Despite the experienced surgical technique, the implementation of modern perioperative programs and the improvement of surgical instruments, the incidence of complications is still high (6)(7)(8). Complications can increase hospital stay and costs (9).…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

et al. 2022

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PurposeThe purpose of this study is to explore the oncologic outcomes of complications on colorectal cancer (CRC) patients who underwent primary surgery using a propensity score matching (PSM) analysis.MethodsA retrospective study was conducted from Jan 2011 to Jan 2020 in a clinical center. The overall survival (OS) and disease-free survival (DFS) were compared among the no complications group, the major complications group and the minor complications group.ResultsA total of 4250 CRC patients who underwent radical primary surgery were included in the current study. Among them, 927 (21.8%) patients suffered complications. After 1:1 ratio PSM, there were 98 patients in the major complications group and in the minor complications group, and 911 patients in the overall complications group and in the no complications group. There was no significant difference in terms of baseline information after PSM (p>0.05). Complications were independent predictors of OS (p=0.000, HR=1.693, 95% CI=1.476-1.941) and DFS (p=0.000, HR=1.555, 95% CI=1.367-1.768). In terms of specific tumor stage, the no complications group had better OS on all stages (p=0.006) and stage III (p=0.003) CRC than the complications group after PSM. Furthermore, the no complications group had better DFS on all stages (p=0.005) and stage III (p=0.021) CRC than the complications group after PSM. However, there was no significant difference between the minor complications group and the major complications group in different tumor stages (p>0.05).ConclusionComplications were associated with poor prognosis of CRC and surgeons should be cautious of the adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

et al. 2022

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“…These complications were defined as National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 [CTCAE] grade 3 or 4. Major problems were characterized as CTCTAE grades 1 or 2, and patients who had them had a substantially worse prognosis than those who did not (HR1.62, 95% CI1.21-2.18, P<0.01) ( 38 ). As a result, some oncologists advocate using chemotherapy as the first-line treatment option, as they are concerned about the impact of postoperative complications, particularly when patients experience a deteriorating physical condition (e.g., weight loss and malnutrition) after surgery.…”

Section: Risks Of Ptr In Crc Patients With Incurable Metastasesmentioning

confidence: 99%

Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview

et al. 2023

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Colorectal cancer (CRC) is the second most common cause of cancer-related death among both men and women worldwide and the third most common cancer overall. About 20% of patients diagnosed with CRC were discovered to have distant metastatic lesions, the majority of which were located in the liver. For the optimum treatment of CRC patients with hepatic metastases, interventional radiologists, medical oncologists, and surgeons must all collaborate. The surgical excision of the primary tumor is an important part of CRC treatment since it has been found to be curative in cases of CRC with minimal metastases. However, given the evidence to date was gathered from retrospective data, there is still controversy over the effectiveness of primary tumor resection (PTR) in improving the median overall survival (OS) and quality of life. Patients who have hepatic metastases make up a very tiny fraction of those who are candidates for resection. With a focus on the PTR, this minireview attempted to review the current advancements in the treatment options for hepatic colorectal metastatic illness. This evaluation also included information on PTR’s risks when performed on individuals with stage IV CRC.

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“…[1][2][3][4] PIC is known to lead to increases in treatment cost and prolonged hospital stays, and the lack of effective adjuvant therapy is often attributed to PICs. 5,6 In addition, there is increasing evidence that PIC is associated with unfavorable long-term outcomes in various malignancies, such as gastric cancer, 7 colorectal cancer, [8][9][10] breast cancer, 11,12 and esophageal cancer. 13 However, there is no consensus regarding the precise mechanism(s) relating poor long-term survival to PICs.…”

Section: Introductionmentioning

confidence: 99%

Pivotal role of myeloid‐derived suppressor cells in infection‐related tumor growth

Ito,

Tsujimoto,

Miyazaki

et al. 2024

Cancer Medicine

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BackgroundIn this study, we investigated infection‐related tumor growth, focusing on myeloid‐derived suppressor cells (MDSCs) in clinical and experimental settings.Patients and MethodsIn the clinical study, a total 109 patients who underwent gastrectomy or esophagectomy were included. Blood samples were collected from a preoperative time point through 3 months after surgery, and MDSCs were analyzed using flow cytometry. In animal experiments, peritonitis model mice were created by CLP method. We investigated the number of splenic MDSCs in these mice using flow cytometry. Malignant melanoma cells (B16F10) were inoculated on the back of the mice, and tumor growth was monitored. We compared the level of MDSC infiltration around the tumor and the migration ability between CLP and sham‐operated mice‐derived MDSCs. Finally, we focused on PD‐L1+MDSCs to examine the effectiveness of anti‐PD‐L1 antibodies on tumor growth in CLP mice.ResultsIn patients with postoperative infectious complication, MDSC number was found to remain elevated 3 months after surgery, when the inflammatory responses were normalized. CLP mice showed increased numbers of MDSCs, and following inoculation with B16F10 cells, this higher number of MDSCs was associated with significant tumor growth. CLP‐mice‐derived MDSCs had higher levels of accumulation around the tumor and had more enhanced migration ability. Finally, CLP mice had increased numbers of PD‐L1+MDSCs and showed more effective inhibition of tumor growth by anti‐PD‐L1 antibodies compared to sham‐operated mice.ConclusionLong‐lasting enhanced MDSCs associated with infection may contribute to infection‐related tumor progression.

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Impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer: A multicenter retrospective cohort study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 9 publications

References 30 publications

The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

The Effect of Complications on Oncological Outcomes of Colorectal Cancer Patients After Primary Surgery: A Propensity Score Matching Analysis

Primary tumor resection in colorectal cancer patients with unresectable distant metastases: a minireview

Pivotal role of myeloid‐derived suppressor cells in infection‐related tumor growth

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