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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2016

01-09-2016 | Colorectal Cancer

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

Authors: A. J. Breugom, MD, D. T. van Dongen, MD, E. Bastiaannet, PhD, F. W. Dekker, PhD, L. G. M. van der Geest, MSc, G. J. Liefers, MD, PhD, A. W. K. S. Marinelli, MD, PhD, W. E. Mesker, PhD, J. E. A. Portielje, MD, PhD, W. H. Steup, MD, PhD, L. N. L. Tseng, MD, C. J. H. van de Velde, MD, PhD, J. W. T. Dekker, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2016

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Abstract

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.
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Metadata
Title
Association Between the Most Frequent Complications After Surgery for Stage I–III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences
Authors
A. J. Breugom, MD
D. T. van Dongen, MD
E. Bastiaannet, PhD
F. W. Dekker, PhD
L. G. M. van der Geest, MSc
G. J. Liefers, MD, PhD
A. W. K. S. Marinelli, MD, PhD
W. E. Mesker, PhD
J. E. A. Portielje, MD, PhD
W. H. Steup, MD, PhD
L. N. L. Tseng, MD
C. J. H. van de Velde, MD, PhD
J. W. T. Dekker, MD, PhD
Publication date
01-09-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 9/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5226-z

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