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Which comorbid conditions predict complications after surgery for colorectal cancer?

Abstract：

BACKGROUND:Accurate presurgical assessment is important to anticipate postoperative complications, especially in the growing proportion of elderly cancer patients. We designed a study to define which comorbid conditions at the time of diagnosis predict complications after surgery for colorectal cancer. PATIENTS:A random sample of 431 patients recorded in the population-based Eindhoven Cancer Registry who underwent resection for stage I-III colorectal cancer, newly diagnosed between 1995 and 1999 were entered into this study. METHODS:The influence of specific comorbid conditions on the incidence and type of complications after surgery for colorectal cancer was analyzed. RESULTS:Overall, patients with comorbidity did not develop more surgical complications. However, patients with a tumor located in the colon who suffered from concomitant chronic obstructive pulmonary disease (COPD) more often developed pneumonia (18% versus 2%; P = 0.0002) and hemorrhage (9% versus 1%; P = 0.02). Patients with colon cancer who suffered from deep vein thrombosis (DVT) at the time of cancer diagnosis more often had surgical complications (67% versus 30%; P = 0.04), especially more minor infections (44% versus 11%; P = 0.002) and major infections (56% versus 10%; P < 0.0001), pneumonia (22% versus 2%; P = 0.01), and thromboembolic complications (11% versus 3%; P = 0.02). Patients with a tumor located in the rectum who suffered from COPD more frequently had any surgical complication (73% versus 46%; P = 0.04), and the presence of DVT at the time of cancer diagnosis was predictive of thromboembolic complications (17% versus 4%; P = 0.045). The presence of DVT remained significant after adjustment for relevant patient and tumor characteristics (odds ratio 9.0, 95% confidence interval 1.1-27.9). CONCLUSIONS:Among patients undergoing surgery for colorectal cancer, development of complications was especially predicted by presence of COPD and DVT. In patients with the latter comorbidity, regulation of the pre- and postsurgical hemostatic balance needs full attention.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Lemmens VE,Janssen-Heijnen ML,Houterman S,Verheij KD,Martijn H,van de Poll-Franse L,Coebergh JW

doi

10.1007/s00268-005-0711-8

subject

Has Abstract

pub_date

2007-01-01 00:00:00

pages

192-9

issue

eissn

0364-2313

issn

1432-2323

journal_volume

pub_type

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Which comorbid conditions predict complications after surgery for colorectal cancer?