Association Between the Most Frequent Complications After Surgery for Stage I-III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences.

Autor: Breugom AJ; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands. a.j.breugom@lumc.nl., van Dongen DT; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands., Bastiaannet E; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands., Dekker FW; Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands., van der Geest LG; Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands., Liefers GJ; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands., Marinelli AW; Department of Surgery, Medical Centre Haaglanden, The Hague, The Netherlands., Mesker WE; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands., Portielje JE; Department of Internal Medicine, HAGA Hospital, The Hague, The Netherlands., Steup WH; Department of Surgery, HAGA Hospital, The Hague, The Netherlands., Tseng LN; Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands., van de Velde CJ; Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands., Dekker JW; Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2016 Sep; Vol. 23 (9), pp. 2858-65. Date of Electronic Publication: 2016 Apr 13.
DOI: 10.1245/s10434-016-5226-z
Abstrakt: Background: The purpose of this study was to identify the ten most frequent complications after surgery for stage I-III colon cancer and to assess the association between these complications and overall survival, conditional overall survival, and recurrences.
Methods: All patients who underwent surgery for stage I-III colon cancer in five hospitals in the Western region of the Netherlands were identified. Crude and adjusted Cox proportional hazards models were used to study the association between complications and 1-year overall survival, 5-year overall survival, 5-year conditional overall survival, and 5-year disease-free period.
Results: Data from 761 patients were used for the analyses. Complications were associated with decreased 1-year overall survival (hazard ratio (HR) 2.87, 95 % confidence interval (CI) 1.82-4.51; p < 0.001), 5-year overall survival (HR 1.59, 95 % CI 1.25-2.04; p < 0.001), and 5-year conditional overall survival (HR 1.34, 95 % CI 1.06-1.69; p = 0.016), whereas an increasing number of complications had no additional impact. Anastomotic leakage, excessive blood loss, and (abdominal) sepsis were associated with reduced 1-year overall survival, anastomotic leakage, delirium, abscess, and (abdominal) sepsis with reduced 5-year overall survival, and anastomotic leakage, delirium, and abscess with reduced 5-year conditional overall survival. Anastomotic leakage, electrolyte disorders, and abscess were risk factors for recurrence within five years.
Conclusions: Our results demonstrate the serious impact of the most frequent complications after surgery for colon cancer on short-term and long-term outcomes. This study confirms the prolonged impact of surgery and demonstrates that complications result not only in reduced 1-year survival, but also in reduced long-term outcomes.
Databáze: MEDLINE
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