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International Journal of Colorectal Disease

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Open Access 01-06-2020 | Colon Cancer | Original Article

The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma

Authors: Clemens Beck, Klaus Weber, Maximilian Brunner, Abbas Agaimy, Sabine Semrau, Robert Grützmann, Vera Schellerer, Susanne Merkel

Published in: International Journal of Colorectal Disease | Issue 6/2020

Abstract

Background

The impact of postoperative complications (POCs) on the long-term prognosis of patients with colorectal carcinoma was analysed with respect to their severity according to the Clavien-Dindo classification (CDC).

Methods

The prospectively collected data of 2158 patients who underwent curative resection of a colorectal carcinoma (1168 rectal carcinomas, 990 colon carcinomas) without distant metastases from 1995 to 2014 were analysed. The POCs were documented in a standardized form and graded with the CDC. Patients who died postoperatively (CDC grade V, 1.7%) were excluded.

Results

In total, 467 patients (21.6%) had POCs: CDC I, 141 (6.5%); CDC II, 162 (7.5%); CDC III, 112 (5.2%); and CDC IV, 52 (2.4%). More POCs and higher CDC grades were found in men, ASA III-IV patients, rectal carcinoma patients, and patients who underwent abdominoperineal excisions or multivisceral resections. The 5-year locoregional recurrence rate was 5.3% in patients without POCs and 6.6% in patients with POCs. It was highest in CDC III patients (12.9%), which was confirmed in multivariate analysis (HR 2.2; p = 0.005). The 5-year distant metastasis rate was 15.9% in CDC 0 patients and 19.5% in CDC I–IV patients. In multivariate analysis, distant metastasis was highest in CDC III patients (HR 1.7; p = 0.020). The 5-year overall survival rate was 83.5% in patients without POCs and 73.5% in patients with POCs. It was worst in CDC IV patients (63.1%), which was confirmed by multivariate analysis (HR 1.9; p = 0.001).

Conclusion

Patients with POCs after colorectal surgery have a poor long-term prognosis. As the CDC grade increases, survival deteriorates.

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Title: The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma
Authors: Clemens Beck
Klaus Weber
Maximilian Brunner
Abbas Agaimy
Sabine Semrau
Robert Grützmann
Vera Schellerer
Susanne Merkel
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Colon Cancer
Colorectal Cancer
Colon Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 6/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03557-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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