Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

Toru Aoyama, Koji Oba, Michitaka Honda, Sotaro Sadahiro, Chikuma Hamada, Shuhei Mayanagi, Mitsuro Kanda, Hiromichi Maeda, Kosuke Kashiwabara, Junichi Sakamoto, Shigetoyo Saji, Takaki Yoshikawa

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22 Citations (Scopus)

Abstract

This study assessed the impact of postoperative complications on the colorectal cancer survival and recurrence after curative surgery using pooled individual patients’ data from three large phase III randomized trials. In total, 5530 patients were included in this study. The patients were classified as those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for the overall survival (OS) and the disease-free survival (DFS) were analyzed. Postoperative complications were found in 861 (15.6%) of the 5530 patients. The OS and DFS rates at 5 years after surgery were 68.9% and 74.8%, respectively, in the C group and 75.8% and 82.2%, respectively, in the NC group, values that were significantly different between the two groups (P < 0.001). The multivariate analysis demonstrated that postoperative complications were a significant independent risk factor for the OS and DFS. Postoperative complications can worsen the colorectal cancer survival and risk of recurrence. Surgical morbidity must be considered as a stratification factor in future phase III trials evaluating the effects of adjuvant chemotherapy on colorectal cancer.

Original languageEnglish
Pages (from-to)1573-1580
Number of pages8
JournalCancer medicine
Volume6
Issue number7
DOIs
Publication statusPublished - 2017 Jul

Keywords

  • Colorectal cancer
  • recurrence
  • surgical complication
  • survival

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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    Aoyama, T., Oba, K., Honda, M., Sadahiro, S., Hamada, C., Mayanagi, S., Kanda, M., Maeda, H., Kashiwabara, K., Sakamoto, J., Saji, S., & Yoshikawa, T. (2017). Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials. Cancer medicine, 6(7), 1573-1580. https://doi.org/10.1002/cam4.1126