Department of Medicine, Keimyung University School of Medicine, Daegu, Korea.
Department of Surgery, School of Medicine, Dongsan Medical Center, Keimyung University, Dalgubeol-Daero, Dalseo-Gu, 1035, Daegu, Republic of Korea.
Int J Colorectal Dis. 2024 Nov 7;39(1):179. doi: 10.1007/s00384-024-04730-8.
The purpose of this study was to investigate the effects of postoperative complications on long-term survival after laparoscopic surgery for resectable colorectal cancer.
We retrospectively included 204 patients who underwent laparoscopic surgery for colorectal cancer from January 2016 to June 2020.
Overall, 68 (33.3%) patients had postoperative complications, twelve (17.6%) of which were classified as Clavien-Dindo class 3a or higher. The 5-year overall survival rate of the non-complication and complication groups were 93.0% and 81.7%, respectively (p = 0.048; Kaplan-Meier analysis and log-rank test), and those among patients with stage III disease were 87.0% and 61.3%, respectively (p = 0.045). The 5-year disease-free survival rates were 85.6% and 77.4%, respectively (p = 0.042). Multivariable Cox proportional-hazards analysis revealed that nodal stage (hazard ratio, 8.392; 95% confidence interval, 1.892-37.175; p = 0.005) was an independent prognostic factor for overall survival, and postoperative complications (hazard ratio, 2.996; 95% confidence interval, 1.076-8.340; p = 0.036) were independent prognostic factors for disease-free survival.
Postoperative complications were associated with poor oncological outcomes, especially among patients with stage III colorectal cancer, and independent prognostic factors for disease-free survival.
本研究旨在探讨术后并发症对腹腔镜结直肠癌根治术后长期生存的影响。
我们回顾性纳入了 2016 年 1 月至 2020 年 6 月接受腹腔镜结直肠癌手术的 204 例患者。
总体而言，68 例（33.3%）患者发生术后并发症，其中 12 例（17.6%）为 Clavien-Dindo 分级 3a 或更高。无并发症组和并发症组的 5 年总生存率分别为 93.0%和 81.7%（p=0.048；Kaplan-Meier 分析和对数秩检验），其中 III 期疾病患者的 5 年总生存率分别为 87.0%和 61.3%（p=0.045）。无复发生存率分别为 85.6%和 77.4%（p=0.042）。多变量 Cox 比例风险分析显示，淋巴结分期（风险比，8.392；95%置信区间，1.892-37.175；p=0.005）是总生存的独立预后因素，术后并发症（风险比，2.996；95%置信区间，1.076-8.340；p=0.036）是无复发生存的独立预后因素。
术后并发症与较差的肿瘤学结果相关，尤其是在 III 期结直肠癌患者中，并且是无复发生存的独立预后因素。
