Prognostic significance of complications after laparoscopic colectomy for colon cancer

PLoS One. 2014 Oct 9;9(10):e108348. doi: 10.1371/journal.pone.0108348. eCollection 2014.

Abstract

Aims: This study sought to evaluate the prognostic significance of postoperative complications for colon cancer patients undergoing laparoscopic surgery.

Methods: From May 2006 to May 2009, a total 224 patients who underwent laparoscopic curative resection (R0) for colon cancer were included in our retrospective study. Postoperative complications were evaluated according to a standardized grading system. The main outcome measurements of our study were overall survival (OS) and relapse-free survival (RFS), which were then compared between the no complication and complication groups. Univariate and multivariate analysis were used to assess the correlation between complications and prognosis.

Results: Fifty-nine postoperative complications occurred in 43 patients. The overall morbidity rate was 26.3%. The 5-year OS in the complication group was 41.4% compared with 78.5% in the no complication group (P<0.001). The cumulative incidence of relapse was also more aggressive in patients with complications (5-year RFS: complication group 40.9% vs. no complication group 82.1%, P<0.001). Multivariate analysis identified complications as a significant factor increasing the risk for both OS (RR 2.737; 95% CI 1.512-4.952; P = 0.001) and RFS (RR 4.247; 95% CI 2.291-7.876; P<0.001).

Conclusion: Postoperative complications could pose a significant adverse impact not only on OS but also on RFS in patients with colon cancer even when laparoscopic R0 resection is available.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Colectomy / adverse effects*
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy / adverse effects*
  • Male
  • Neoplasm Recurrence, Local / etiology
  • Postoperative Complications
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome

Grants and funding

This work was supported by the National Natural Science Foundation of China (No. 81372640). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.