BACKGROUND: The negative impact of postoperative complications (POCs) on long-term outcomes is well documented for several cancer surgeries, but conclusive evidence has yet to be provided on the influence of POCs on long-term oncological outcomes after hepatic resection for colorectal liver metastasis (CRLM). METHODS: Studies published through February 2012 evaluating the oncological impact of POCs after hepatectomy for CRLM were identified by an electronic literature search. Finally, 4 studies were identified and included in the meta-analysis. The main outcome measures were 5-year disease-free survival (DFS) and overall survival (OS). A meta-analysis was performed using the DerSimonian-Laird random-effects models to compute odds ratio (OR) along with 95 % confidence intervals (95 % CI). RESULTS: The outcomes of 2,280 patients were studied. Meta-analysis of 5-year DFS data extracted from three studies demonstrated a significant reduction in 5-year DFS after POCs, with an OR of 1.98 (95 % CI = 1.33-2.96; P = .0008). Meta-analysis of 5-year OS data extracted from four studies demonstrated a significant reduction in 5-year OS after POCs, with an OR of 1.68 (95 % CI = 1.25-2.27; P = .0006). No differences between study heterogeneity were observed in either the DFS or the OS analyses. CONCLUSIONS: This study provides persuasive evidence that POCs following hepatic resection for CRLM have significant adverse oncological outcomes. These findings emphasize the need for meticulous surgical technique and careful perioperative management to minimize POCs.
BACKGROUND: The negative impact of postoperative complications (POCs) on long-term outcomes is well documented for several cancer surgeries, but conclusive evidence has yet to be provided on the influence of POCs on long-term oncological outcomes after hepatic resection for colorectal liver metastasis (CRLM). METHODS: Studies published through February 2012 evaluating the oncological impact of POCs after hepatectomy for CRLM were identified by an electronic literature search. Finally, 4 studies were identified and included in the meta-analysis. The main outcome measures were 5-year disease-free survival (DFS) and overall survival (OS). A meta-analysis was performed using the DerSimonian-Laird random-effects models to compute odds ratio (OR) along with 95 % confidence intervals (95 % CI). RESULTS: The outcomes of 2,280 patients were studied. Meta-analysis of 5-year DFS data extracted from three studies demonstrated a significant reduction in 5-year DFS after POCs, with an OR of 1.98 (95 % CI = 1.33-2.96; P = .0008). Meta-analysis of 5-year OS data extracted from four studies demonstrated a significant reduction in 5-year OS after POCs, with an OR of 1.68 (95 % CI = 1.25-2.27; P = .0006). No differences between study heterogeneity were observed in either the DFS or the OS analyses. CONCLUSIONS: This study provides persuasive evidence that POCs following hepatic resection for CRLM have significant adverse oncological outcomes. These findings emphasize the need for meticulous surgical technique and careful perioperative management to minimize POCs.
Authors: Afif N Kulaylat; Neil H Bhayani; Audrey L Stokes; Jane R Schubart; Joyce Wong; Eric T Kimchi; Kevin F Staveley-O'Carroll; Jussuf T Kaifi; Niraj J Gusani Journal: J Gastrointest Surg Date: 2014-06-21 Impact factor: 3.452
Authors: Joachim Andrassy; Sebastian Wolf; Verena Hoffmann; Markus Rentsch; Manfred Stangl; Michael Thomas; Sebastian Pratschke; Lorenz Frey; Alexander Gerbes; Bruno Meiser; Martin Angele; Jens Werner; Markus Guba Journal: Langenbecks Arch Surg Date: 2016-03-10 Impact factor: 3.445
Authors: Ching-Wei D Tzeng; Hop S Tran Cao; Jeffrey E Lee; Peter W T Pisters; Gauri R Varadhachary; Robert A Wolff; James L Abbruzzese; Christopher H Crane; Douglas B Evans; Huamin Wang; Daniel E Abbott; Jean-Nicolas Vauthey; Thomas A Aloia; Jason B Fleming; Matthew H G Katz Journal: J Gastrointest Surg Date: 2013-11-16 Impact factor: 3.452