The Impact of Perioperative Risk, Tumor Pathology and Surgical Complications on Disease Recurrence Following Potentially Curative Resection of Colorectal Cancer

Richards, Colin H.; Platt, Jonathan J.; Anderson, John H.; McKee, Ruth F.; Horgan, Paul G.; McMillan, Donald C.

doi:10.1097/sla.0b013e31821fd469

Cited by 63 publications

(52 citation statements)

References 36 publications

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“…The postoperative surgical complications were reported based not on the study protocol but on the judgment of individual physicians. Although the incidence of morbidity in this study was similar to that in other large studies 19, 20, some surgical complications might have been underestimated.…”

Section: Discussionsupporting

confidence: 85%

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

et al. 2017

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This study assessed the impact of postoperative complications on the colorectal cancer survival and recurrence after curative surgery using pooled individual patients’ data from three large phase III randomized trials. In total, 5530 patients were included in this study. The patients were classified as those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for the overall survival (OS) and the disease‐free survival (DFS) were analyzed. Postoperative complications were found in 861 (15.6%) of the 5530 patients. The OS and DFS rates at 5 years after surgery were 68.9% and 74.8%, respectively, in the C group and 75.8% and 82.2%, respectively, in the NC group, values that were significantly different between the two groups (P < 0.001). The multivariate analysis demonstrated that postoperative complications were a significant independent risk factor for the OS and DFS. Postoperative complications can worsen the colorectal cancer survival and risk of recurrence. Surgical morbidity must be considered as a stratification factor in future phase III trials evaluating the effects of adjuvant chemotherapy on colorectal cancer.

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Section: Discussionsupporting

confidence: 85%

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

et al. 2017

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“…Postoperative morbidity was higher in the right hemicolectomies, which is in agreement with the data from several studies (30). This has been linked to older age, the need for blood products during surgery and a greater number of open surgeries at this location (30,31).…”

Section: Discussionsupporting

confidence: 81%

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

et al. 2017

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“…Therefore, the preoperative physiological status can be a confounding factor in the evaluation of postoperative complications and late mortality. Richards et al 82. have analyzed the effects of various perioperative factors on disease recurrence in patients with colorectal cancer.…”

Section: Resultsmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

104

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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The Impact of Perioperative Risk, Tumor Pathology and Surgical Complications on Disease Recurrence Following Potentially Curative Resection of Colorectal Cancer

Abstract: Preoperative risk factors, but not postoperative complications, are associated with early disease recurrence after potentially curative resection of colorectal cancer.

Cited by 63 publications

References 36 publications

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

Clinico-pathological and oncological differences between right and left-sided colon cancer (stages I-III): analysis of 950 cases

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

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