A J Breugom1, D T van Dongen2, E Bastiaannet2,3, F W Dekker4, L G M van der Geest5, G J Liefers2, A W K S Marinelli6, W E Mesker2, J E A Portielje7, W H Steup8, L N L Tseng9, C J H van de Velde2, J W T Dekker10. 1. Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands. a.j.breugom@lumc.nl. 2. Department of Surgery, Leiden University Medical Centre, Leiden, The Netherlands. 3. Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, The Netherlands. 4. Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands. 5. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. 6. Department of Surgery, Medical Centre Haaglanden, The Hague, The Netherlands. 7. Department of Internal Medicine, HAGA Hospital, The Hague, The Netherlands. 8. Department of Surgery, HAGA Hospital, The Hague, The Netherlands. 9. Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands. 10. Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands.
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.
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.
Authors: C Simillis; M Charalambides; A Mavrou; T Afxentiou; M P Powar; J Wheeler; R J Davies; N S Fearnhead Journal: Tech Coloproctol Date: 2022-09-22 Impact factor: 3.699
Authors: Maria Charalambides; Athina Mavrou; Thomas Jennings; Michael P Powar; James Wheeler; R Justin Davies; Nicola S Fearnhead; Constantinos Simillis Journal: Int J Colorectal Dis Date: 2021-10-26 Impact factor: 2.571
Authors: Max P L van der Sijp; Esther Bastiaannet; Wilma E Mesker; Lydia G M van der Geest; Anne J Breugom; Willem H Steup; Andreas W K S Marinelli; Larissa N L Tseng; Rob A E M Tollenaar; Cornelis J H van de Velde; J W T Dekker Journal: Int J Colorectal Dis Date: 2016-08-06 Impact factor: 2.571