Ann Coloproctol.  2020 Aug;36(4):273-280. 10.3393/ac.2019.10.15.

Long-term Oncologic Outcome of Postoperative Complications After Colorectal Cancer Surgery

• Oh CK
• Huh JW
• Lee YJ
• Choi MS
• Pyo DH
• Lee SC
• Park SM
• Shin JK
• Park YA
• Cho YB
• Yun SH
• Kim HC
• Lee WY

• KMID: 2506129
• DOI: http://doi.org/10.3393/ac.2019.10.15

Abstract

Purpose
The impact of postoperative complications on long-term oncologic outcome after radical colorectal cancer surgery is controversial. The aim of this study was to examine the risk factors and oncologic outcomes of surgery-related postoperative complication groups.
Methods
From January 2010 to December 2010, 310 patients experienced surgery-related postoperative complications after radical colorectal cancer surgery. These stage I–III patients were classified into 2 subgroups, minor (grades I, II) and major (grades III, IV) complication groups, according to extended Clavien-Dindo classification system criteria. Clinicopathologic differences between the 2 groups were analyzed to identify risk factors for major complications. The diseasefree survival rates of surgery-related postoperative complication groups were also compared.
Results
Minor and major complication groups were stratified with 194 patients (62.6%) and 116 patients (37.4%), respectively. The risk factors influencing the major complication group were pathologic N category and operative method. The prognostic factors associated with disease-free survival were preoperative perforation, perineural invasion, tumor budding, and receiving neoadjuvant therapy. With a median follow-up period of 72.2 months, the 5-year disease-free survival rates were 84.4% in the minor group and 78.5% in the major group, but there was no statistical significance between the minor and major groups (P = 0.392).
Conclusion
Advanced cancer and open surgery were identified as risk factors for increased surgery-related major complications after radical colorectal cancer surgery. However, severity of postoperative complications did not affect disease-free survival from colorectal cancer.

Keyword

Postoperative complications; Colorectal cancer surgery; Risk factor; Recurrence