Annals of Gastroenterological Surgery (May 2021)

Impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer: A multicenter retrospective cohort study

  • Yusuke Fujita,
  • Koya Hida,
  • Nobuaki Hoshino,
  • Yoshiharu Sakai,
  • Tsuyoshi Konishi,
  • Akiyoshi Kanazawa,
  • Michitoshi Goto,
  • Shuji Saito,
  • Tadashi Suda,
  • Masahiko Watanabe,
  • Japan Society of Laparoscopic Colorectal Surgery

DOI
https://doi.org/10.1002/ags3.12433
Journal volume & issue
Vol. 5, no. 3
pp. 354 – 362

Abstract

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Abstract Aims Primary tumor resection for patients with incurable stage IV colorectal cancer can prevent tumor‐related complications but may cause postoperative complications. Postoperative complications delay the administration of chemotherapy and can lead to the spread of malignancy. However, the impact of postoperative complications after primary tumor resection on survival in patients with incurable stage IV colorectal cancer remains unclear. Therefore, this study aimed to investigate how postoperative complications after primary tumor resection affect survival in this patient group. Methods We reviewed data on 966 patients with stage IV colorectal cancer who underwent palliative primary tumor resection between January 2006 and December 2007. We examined the association between major complications (National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 grade 3 or more) and overall survival using Cox proportional hazard model and explored risk factors associated with major complications using multivariable logistic regression analysis. Results Ninety‐three patients (9.6%) had major complications. The 2‐year overall survival rate was 32.7% in the group with major complications and 50.3% in the group with no major complications. Patients with major complications had a significantly poorer prognosis than those without major complications (hazard ratio: 1.62; 95% confidence interval: 1.21‐2.18; P < .01). Male, rectal tumor, and open surgery were identified to be risk factors for major complications. Conclusions Postoperative complications after primary tumor resection was associated with decreased long‐term survival in patients with incurable stage IV colorectal cancer.

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