Riccardo Memeo1,2,3, Vito de Blasi1,2,3, Rene Adam4, Diane Goéré5, Alexis Laurent6, Nicola de'Angelis6, Tullio Piardi7, Emilie Lermite8, Astrid Herrero9, Francis Navarro9, Antonio Sa Cunha4, Patrick Pessaux10,11,12,13. 1. Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. 2. Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. 3. General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg, France. 4. Department of Surgery, Hôpital Paul Brousse, Villejuif, France. 5. Department of Surgery, Institut Gustave Roussy, Villejuif, France. 6. Department of Surgery, Hôpital Henri Mondor, Créteil, France. 7. Department of Surgery, Hôpital de Robert Debré, Reims, France. 8. Department of Surgery, Centre Hospitalo-Universitaire, Angers, France. 9. Department of Digestive Surgery, Hôpital Saint-Eloi, Montpellier, France. 10. Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. 11. Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. 12. General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. 13. , Strasbourg, France. patrick.pessaux@chru-strasbourg.fr.
Abstract
OBJECTIVE: Postoperative complications strongly impact the postoperative course and long-term outcome of patients who underwent liver resection for colorectal liver metastases (CRLM). Among them, infectious complications play a relevant role. The aim of this study was to evaluate if infectious complications still impact overall and disease-free survival after liver resection for CRLM once patients were matched with a propensity score matching analysis based on Fong's criteria. METHODS: A total of 2281 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched with a 1:3 propensity score analysis in order to compare patients with (INF+) and without (INF-) postoperative infectious complications. RESULTS: Major resection (OR = 1.69 (1.01-2.89), p = 0.05) and operative time (OR = 1.1 (1.1-1.3), p = 0.05) were identified as risk factors of infectious complications. After propensity score matching, infectious complications are associated with overall survival (OS), with 1-, 3-, 5-year OS at 94, 81, and 66% in INF- and 92, 66, and 57% in INF+ respectively (p = 0.01). Disease-free survival (DFS) was also different with regard to 1-, 3-, 5-year survival at 65, 41, and 22% in R0 vs. 50, 28, and 17% in INF+ (p = 0.007). CONCLUSION: Infectious complications are associated with decreased overall and disease-free survival rates.
OBJECTIVE: Postoperative complications strongly impact the postoperative course and long-term outcome of patients who underwent liver resection for colorectal liver metastases (CRLM). Among them, infectious complications play a relevant role. The aim of this study was to evaluate if infectious complications still impact overall and disease-free survival after liver resection for CRLM once patients were matched with a propensity score matching analysis based on Fong's criteria. METHODS: A total of 2281 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched with a 1:3 propensity score analysis in order to compare patients with (INF+) and without (INF-) postoperative infectious complications. RESULTS: Major resection (OR = 1.69 (1.01-2.89), p = 0.05) and operative time (OR = 1.1 (1.1-1.3), p = 0.05) were identified as risk factors of infectious complications. After propensity score matching, infectious complications are associated with overall survival (OS), with 1-, 3-, 5-year OS at 94, 81, and 66% in INF- and 92, 66, and 57% in INF+ respectively (p = 0.01). Disease-free survival (DFS) was also different with regard to 1-, 3-, 5-year survival at 65, 41, and 22% in R0 vs. 50, 28, and 17% in INF+ (p = 0.007). CONCLUSION: Infectious complications are associated with decreased overall and disease-free survival rates.
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