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World Journal of Surgery
Published in: World Journal of Surgery 7/2015

01-07-2015 | Original Scientific Report

Postoperative Complications Affect Long-Term Survival Outcomes Following Hepatic Resection for Colorectal Liver Metastasis

Authors: Zi Yin, Xiande Huang, Tingting Ma, Haosheng Jin, Ye Lin, Min Yu, Zhixiang Jian

Published in: World Journal of Surgery | Issue 7/2015

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Abstract

Background

The impact of postoperative complications (POCs) on long-term survival outcomes following hepatic resection for colorectal liver metastasis (CRLM) is in controversy. The aim of the present meta-analysis was to systematically evaluate the POC effect on overall survival (OS) and disease-free survival (DFS) in patients undergoing hepatic resection for CRLM.

Methods

We conducted a systematic review and meta-analysis of all observational studies to evaluate the POC effect on OS and DFS in patients undergoing hepatic resection for CRLM. A search for all major databases and relevant journals from inception to January 2014 without restriction on languages or regions was performed. POCs were extracted and graded according to a validated system of classification. Outcome measures were postoperative 1-, 2-, 3-, and 10-year OSs and DFSs. Both random-effects and fixed-effect models were used to pool the hazard ratios (HRs) of the survival outcomes. Test of heterogeneity was performed with the Q statistic.

Results

A total of 2370 patients were included in the meta-analysis. Both 5- and 10-year postoperative OSs showed significant decreases in patients with POCs (HR = 1.52; 95 % CI 1.27–1.83; P < 0.001 and HR = 1.36; 95 % CI 1.18–1.58; P < 0.001, respectively). Similar outcomes were also observed in terms of DFSs, with the 5- and 10-year HRs found to be 1.37 (95 % CI 1.23–1.53; P < 0.001) and 1.34 (95 % CI 1.17–1.53; P < 0.001), respectively, compared to no POC group.

Conclusions

POCs are strongly related to long-term oncologic outcomes following hepatic resection for CRLM. Further efforts to refine surgical technique and postoperative management to avoid complications may improve the long-term oncological outcomes of the selected patients.
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Metadata
Title
Postoperative Complications Affect Long-Term Survival Outcomes Following Hepatic Resection for Colorectal Liver Metastasis
Authors
Zi Yin
Xiande Huang
Tingting Ma
Haosheng Jin
Ye Lin
Min Yu
Zhixiang Jian
Publication date
01-07-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 7/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3019-3

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