1. Association Between the Most Frequent Complications After Surgery for Stage I-III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences.
- Author
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Breugom AJ, van Dongen DT, Bastiaannet E, Dekker FW, van der Geest LG, Liefers GJ, Marinelli AW, Mesker WE, Portielje JE, Steup WH, Tseng LN, van de Velde CJ, and Dekker JW
- Subjects
- Abscess etiology, Aged, Anastomotic Leak etiology, Arrhythmias, Cardiac etiology, Colonic Neoplasms pathology, Delirium etiology, Disease-Free Survival, Female, Humans, Ileus etiology, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Staging, Pneumonia etiology, Proportional Hazards Models, Sepsis etiology, Survival Rate, Time Factors, Urinary Tract Infections etiology, Water-Electrolyte Imbalance etiology, Colonic Neoplasms surgery, Gastrointestinal Hemorrhage etiology, Postoperative Complications etiology
- 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.
- Published
- 2016
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