Department of Surgery, Hospital of the Brothers of Mercy, St. Veit/Glan, Austria.
Dis Colon Rectum. 2013 Jan;56(1):20-8. doi: 10.1097/DCR.0b013e31826f2672.
The relevance of type and severity of postoperative complications after curative resection for rectal cancer on survival and recurrence rates is a matter of controversy.
The aim of this study was to investigate the impact of postoperative complications on long-term outcome after resection for rectal cancer.
This study is a retrospective analysis of prospectively collected data.
The study was conducted at a university teaching hospital by a specialized colorectal team.
Between January 1984 and October 2008, 811 patients with rectal cancer underwent curative resection. Patients who experienced postoperative complications were divided into a minor complication group (grades I and II) and a major complications group (grades III and IV) according to the Clavien classification.
The influence of several pathological and clinical factors, including complications in terms of overall and disease-free survival, was tested and compared in univariate and multivariate analyses.
Curative resection was performed in 811 patients; median age was 65 years. The Kaplan-Meier estimates (± SE) for 5- and 10-year overall cumulative survival were 70.3% ± 1.8% and 54.5% ± 2.4%; Kaplan-Meier estimates for 5- and 10-year disease-free survival were 64.0% ± 1.8% and 50.9% ± 2.3%. One hundred sixty-five patients (20.3%) had minor complications, and 103 patients (12.7%) had major complications. Twelve patients (1.48%) died within 30 days after surgery. There was no significant difference between patients with no complications, patients with minor complications, and patients with major complications in terms of overall (p = 0.41) or disease-free survival (p = 0.32).
A possible limitation of our study is that the data represent a cohort study from a single center.
Following resection for rectal cancer, the severity of postoperative complications (minor or major) according to a standardized classification system does not demonstrate a statistically significant effect on either overall or disease-free survival.
根治性切除术后并发症的类型和严重程度对直肠癌的生存率和复发率的影响仍存在争议。
本研究旨在探讨术后并发症对直肠癌切除术后长期预后的影响。
这是一项前瞻性收集数据的回顾性分析。
研究在一所大学教学医院由专门的结直肠团队进行。
1984 年 1 月至 2008 年 10 月，811 例直肠癌患者接受了根治性切除术。根据 Clavien 分类，将发生术后并发症的患者分为轻微并发症组（I 级和 II 级）和严重并发症组（III 级和 IV 级）。
在单因素和多因素分析中，测试并比较了包括并发症在内的几个病理和临床因素对总生存和无病生存的影响。
811 例患者均行根治性切除术；中位年龄为 65 岁。5 年和 10 年总累积生存率的 Kaplan-Meier 估计值（± SE）分别为 70.3%±1.8%和 54.5%±2.4%；5 年和 10 年无病生存率的 Kaplan-Meier 估计值分别为 64.0%±1.8%和 50.9%±2.3%。165 例（20.3%）患者发生轻微并发症，103 例（12.7%）患者发生严重并发症。12 例（1.48%）患者术后 30 天内死亡。无并发症、轻微并发症和严重并发症患者的总生存（p=0.41）或无病生存（p=0.32）差异均无统计学意义。
本研究的一个局限性可能是数据代表了来自单一中心的队列研究。
根据标准化分类系统，直肠癌根治性切除术后并发症的严重程度（轻微或严重）与总生存或无病生存无显著统计学相关性。
