Impact of Postoperative Morbidity on Long-Term Survival After Resection for Colorectal Liver Metastases.

BACKGROUND: Although correlation of postoperative morbidity with long-term survival is recognized to influence long-term survival after other cancer surgery, little information exists about the impact of postoperative morbidity on patient outcomes following liver resection for colorectal metastases.
METHODS: We studied the impact of postoperative morbidity on long-term survival after liver resection for colorectal cancer metastases using data from 312 patients with curative hepatectomy.
RESULTS: Among all 312 patients evaluated, 98 complications occurred, affecting 80 patients (26%). The 80 patients with morbidity had a lower disease-free rate (P = 0.03), resulting in poor overall survival (P = 0.02) compared with the group with no morbidity (n = 232). Decreases in disease-free and overall survival also were associated with severity of postoperative complications. When patients were divided according to extent of metastases, little impact of morbidity on overall survival (P = 0.10) and disease-free rate (P = 0.35) was demonstrated in patients whose metastases were less advanced. However, a negative impact of morbidity compared with no morbidity on disease-free rate (P < 0.01) and overall survival (P < 0.01) was confirmed in patients with aggressive or advanced metastases.
CONCLUSIONS: Postoperative morbidity had a negative impact on long-term survival, especially for aggressive or advanced metastases or severe complications.