Postoperative complications affect long-term survival outcomes following hepatic resection for colorectal liver metastasis.

Abstract:

BACKGROUND:The impact of postoperative complications (POCs) on long-term survival outcomes following hepatic resection for colorectal liver metastasis (CRLM) is in controversy. The aim of the present meta-analysis was to systematically evaluate the POC effect on overall survival (OS) and disease-free survival (DFS) in patients undergoing hepatic resection for CRLM. METHODS:We conducted a systematic review and meta-analysis of all observational studies to evaluate the POC effect on OS and DFS in patients undergoing hepatic resection for CRLM. A search for all major databases and relevant journals from inception to January 2014 without restriction on languages or regions was performed. POCs were extracted and graded according to a validated system of classification. Outcome measures were postoperative 1-, 2-, 3-, and 10-year OSs and DFSs. Both random-effects and fixed-effect models were used to pool the hazard ratios (HRs) of the survival outcomes. Test of heterogeneity was performed with the Q statistic. RESULTS:A total of 2370 patients were included in the meta-analysis. Both 5- and 10-year postoperative OSs showed significant decreases in patients with POCs (HR = 1.52; 95 % CI 1.27-1.83; P < 0.001 and HR = 1.36; 95 % CI 1.18-1.58; P < 0.001, respectively). Similar outcomes were also observed in terms of DFSs, with the 5- and 10-year HRs found to be 1.37 (95 % CI 1.23-1.53; P < 0.001) and 1.34 (95 % CI 1.17-1.53; P < 0.001), respectively, compared to no POC group. CONCLUSIONS:POCs are strongly related to long-term oncologic outcomes following hepatic resection for CRLM. Further efforts to refine surgical technique and postoperative management to avoid complications may improve the long-term oncological outcomes of the selected patients.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Yin Z,Huang X,Ma T,Jin H,Lin Y,Yu M,Jian Z

doi

10.1007/s00268-015-3019-3

subject

Has Abstract

pub_date

2015-07-01 00:00:00

pages

1818-27

issue

7

eissn

0364-2313

issn

1432-2323

journal_volume

39

pub_type

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