Effects of Postoperative Morbidity on Long-Term Outcome Following Surgery for Colorectal Liver Metastases

• Published in: World journal of surgery Vol. 39; no. 2; pp. 478 - 486
• Main Authors: Lodewick, T. M., de Jong, M. C., van Dam, R. M., Bemelmans, M. H. A., Neumann, U. P., Olde Damink, S. W. M., Dejong, C. H. C.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.02.2015; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Cardiac Surgery; Clavien Grade; Colorectal Liver Metastasis; Colorectal Neoplasms - pathology; Disease-Free Survival; Female; General Surgery; Hepatectomy - adverse effects; Humans; Liver Neoplasms - pathology; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver Resection; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Original Scientific Report; Overall Survival; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Morbidity; Retrospective Studies; Risk Factors; Surgery; Survival Rate; Thoracic Surgery; Treatment Outcome; Vascular Surgery; Young Adult; Colorectal Liver Metastasis; Liver Resection; Overall Survival; Postoperative Morbidity; Clavien Grade
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-014-2799-1

Background The impact of postoperative complications on long-term outcomes after surgery for colorectal liver metastases (CRLM) remains controversial. During the last decade, advances in surgical as well as non-surgical treatment have increased resectability and altered outcomes. We sought to determine the influence of postoperative morbidity on disease-free (DFS) and overall survival (OS). Methods All patients undergoing liver resection for CRLM for the first time between 2000 and 2011 were retrospectively identified from a prospective database. Postoperative morbidity was classified according to Dindo–Clavien grade. A Dindo–Clavien grade ≥3a was considered a major complication. Primary outcomes were DFS and OS depending on the presence or absence of postoperative morbidity. Results Of the 266 included patients, 97 patients (37 %) developed postoperative complications, of whom 61 (23 %) had major complications. Median DFS and OS (5-year) were 17 and 53 months (42 %). The occurrence of postoperative morbidity did not significantly shorten OS ( p  = 0.130) and DFS ( p  = 0.101). However, major morbidity reduced DFS significantly ( p  < 0.05). Conclusion In the present study, the occurrence of major postoperative complications was associated with diminished DFS. However, the effect of (major) complications on OS did not reach statistical significance.