Department of General and Digestive Surgery, Hospital Universitario Gran Canaria Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.
Department of General and Digestive Surgery, Hospital Universitario Gran Canaria Dr. Negrín, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain.
Surg Oncol. 2022 Jun;42:101780. doi: 10.1016/j.suronc.2022.101780. Epub 2022 May 12.
Postoperative complications after colorectal cancer surgery have been associated with poor long-term prognosis. The aim of the present study was to investigate the prognostic impact of postoperative complications after colorectal cancer surgery assessed by the Comprehensive Complication Index (CCI®) and designing a new prognostic score based on this index.
This observational longitudinal study included a series of 604 patients who underwent colorectal surgery for cancer. Demographic data, comorbidity measured by Charlson Index, tumor characteristics, surgical data and postoperative complications were recorded as predictors. Univariate and multivariate analysis were performed and long-term survival was the output variable. Based on Hazard Ratios obtained on multivariate analysis, a new score, S-CRC-PC, was created for predicting long-term survival.
Two-hundred and twelve (35.1%) patients developed some postoperative complication. The mean CCI was 11.6 (±19.19). Mild complications (CCI <26.2) were detected in 95 (15.7%) patients. Moderate complications (CCI 26.2-42.2) were detected in 64 (10.6%) patients. Severe complications (CCI >42.3) were detected in 53 patients (8.8%) patients. Mortality rate was 1.7%. In multivariate analysis, age (p < 0.001), Charlson score (p = 0.014), CCI (p < 0.001), and TNM stage (p < 0.001) were statistically significantly in relation to long-term survival rate. S-CRC-PC score was statistically associated with survival rate (HR: 1.34-95% CI: 1.27-1.41). Patients with S-CRC-PC values from 0 to 8 points (low risk), 8.1-16 points (medium risk), and scores above 16 points (high risk) had a cumulative survival rate at five-years of 98%, 83%, and 31% respectively.
Postoperative complications after colorectal cancer surgery assessed by CCI are an independent prognostic factor of survival rate. The S-CRC-PC score may be helpful in predicting long-term cancer outcomes.
结直肠癌手术后的并发症与不良的长期预后相关。本研究旨在通过综合并发症指数（CCI®）评估结直肠癌手术后的并发症，并基于该指数设计一种新的预后评分，以探讨其对预后的影响。
本观察性纵向研究纳入了 604 例接受结直肠癌手术的患者。记录人口统计学数据、Charlson 指数评估的合并症、肿瘤特征、手术数据和术后并发症作为预测因素。进行单因素和多因素分析，以长期生存为输出变量。基于多因素分析获得的风险比，创建了一个新的评分，即 S-CRC-PC，用于预测长期生存。
212 例（35.1%）患者发生了某种术后并发症。CCI 的平均值为 11.6（±19.19）。95 例（15.7%）患者发生轻度并发症（CCI<26.2），64 例（10.6%）患者发生中度并发症（CCI 26.2-42.2），53 例（8.8%）患者发生重度并发症（CCI>42.3）。死亡率为 1.7%。多因素分析显示，年龄（p<0.001）、Charlson 评分（p=0.014）、CCI（p<0.001）和 TNM 分期（p<0.001）与长期生存率显著相关。S-CRC-PC 评分与生存率显著相关（HR：1.34-95%CI：1.27-1.41）。S-CRC-PC 值为 0 至 8 分（低风险）、8.1 至 16 分（中风险）和>16 分（高风险）的患者，5 年累积生存率分别为 98%、83%和 31%。
通过 CCI 评估的结直肠癌手术后并发症是生存率的独立预后因素。S-CRC-PC 评分有助于预测结直肠癌患者的长期预后。
