The impact of the type and severity of postoperative complications on long-term outcomes following surgery for colorectal cancer: A systematic review and meta-analysis

Background: This systematic review investigated the impact of complications by type (infective vs. non-infective) and severity (using the Clavien Dindo scale) on long-term outcome following surgery for colorectal cancer.

Methods: A systematic review was performed using appropriate keywords. Meta-analysis using a random effects model was performed.

Results: 14 studies were included with a total 18,611 patients. Infective complications had a significant impact on disease free (HR 1.41, 95%CI 1.08-1.83, p=0.01) and overall survival (1.37 95%CI 1.22-1.55, p<0.001). Non-infective complications had no significant impact on either disease free (HR 1.21, 95%CI 0.97-1.52, p=0.09) or overall survival (HR 1.35, 95%CI 0.92-1.97, p=0.12). Complication severity had a significant impact on both disease free (HR 1.41, 95%CI 1.18-1.68, p<0.001) and overall survival (HR 1.45, 95%CI 1.25-1.69, p<0.001).

Discussion: Both type and severity of postoperative complications have an impact on long-term survival following surgery for colorectal cancer.