Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Selection Criteria, Search Strategies, and Data Collection
2.2. Data Extraction and Synthesis
2.3. Literature Search Results
3. Results
3.1. Classification Systems for Grading POSTOPERATIVE COMPLICATIONS
3.2. Reported Postoperative Complications Grading Systems
3.3. Overall Impact of Postoperative Complications on Cancer Outcomes
3.3.1. Thoracoabdominal Surgery
3.3.2. Surface and Soft Tissue Surgeries
3.4. Subgroup Analysis of Types of Postoperative Complications and Their Impact on Cancer Outcomes
3.4.1. Anastomotic Leak
3.4.2. Wound Complications
Wound-Related Complications in Thoracoabdominal Surgeries
Wound-Related Complications in Surface and Soft Tissue Surgeries
3.4.3. Other Infectious Complications
3.4.4. Non-Infectious Complications
4. Discussion
4.1. Role of Neoadjuvant Chemotherapy on Postoperative Complications
4.2. Postoperative Complications and Delay in Initiation of Adjuvant Treatment
5. Limitations of the Current Literature on Postoperative Complications and Oncological Outcomes
6. Future Research
7. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Studies | Publication Year | Data Duration | Type of Study | No of Institutes (Country) | Cancer Diagnosis | Surgery | Type or Surgery | Sample Size | Age | Age (Statistical Terms) | Female (%) | NACT (%) |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Colorectal | ||||||||||||
Koedam et al. [11] | 2022 | 1997–2003, 2004–2010 | RC | Multicentre (8 countries) | Colorectal CA | Resection anastomosis | Open, Lap | 1076 (COLOR), 764 (COLOR II) | NS | NS | NS | NS |
Bao et al. [12] | 2022 | 2009–2016 | PC | Multicentre (Italy) | Rectal CA | Low anterior resection | open, Lap | 311 | 63.6 ± 10.9 | Mean (SD) | 40.5 | 81 |
Gamboa et al. [13] | 2021 | 2007–2017 | RC | Multicentre (USA) | Rectal CA | Proctectomy (LAR/APR) | Open, Lap, robotic | 1136 | 59 (51–67) | Median (IQR) | 39 | 76 |
Fransgaard et al. [14] | 2021 | 2010–2015 | RC | One (Denmark) | Colorectal CA | NS | NS | 4083 | NS | NS | 45.16 | NS |
Wasmann et al. [3] | 2020 | 2000–2014 | RC | Multicentre (Belgium and Denmark) | Colon CA | Multi-visceral resections | Open, Lap, conversion | 130 | 68 | Mean | 47 | NS |
Oh et al. [15] | 2020 | 2010 | RC | One (Republic of Korea) | Colorectal CA | NS | NS | 310 | 60.5 (32–85) | Mean (Range) | 33.8 | NS |
Miyamoto et al. [16] | 2020 | 2005–2017 | PC | One (Japan) | Colorectal CA | NS | NS | 673 | 69 (19–95) | Median (range) | 39 | NS |
Furnée et al. [17] | 2019 | 2011 | RC | Multicentric (The Netherlands) | Rectal CA | Low anterior resection with primary anastomosis | Open, Lap, conversion | 746 | 57.45 | Mean | NS | NS |
Sprenger et al. [18] | 2018 | 1995–2002 | RC | Multicentre (Germany) | Rectal CA | Resection anastomosis | NS | 799 | 62 (30–77) | Median (range) | 31.4 | 50.8 |
Cienfuegos et al. [19] | 2018 | 2000–2014 | RC | Multicentre (Spain) | Colorectal CA | NS | Open, Lap, conversion | 950 | 66.2 | Mean | 39.05 | NS |
Park et al. [20] | 2016 | 2005–2012 | RC | One (Republic of Korea) | Rectal CA | Low anterior resection | Open, LAP | 686 | 62.2 (28–89) | Mean (range) | 38.63 | NS |
Espin et al. [21] | 2015 | 2006–2008 | RC | Multicentre (Spain) | Rectal CA | Low anterior resection | NS | 1153 | NS | NS | 35.21 | 53.69 |
Krarup et al. [22] | 2014 | 2001–2008 | RC | Multicentre (Denmark) | Colon CA | Resection anastomosis without ostomy | Open, Lap | 8589 | 72 (23–98) | Median (range) | 52.41 | NS |
Kube et al. [23] | 2010 | 2000–2004 | RC | Multicentre (Germany) | Colon CA | Colonic resection with anastomosis | NS | 844 | NS | NS | NS | NS |
Marra et al. [24] | 2009 | 1991–2004 | RC | One (Switzerland) | Colon CA | Resection anastomosis | NS | 440 | 68.6 (22–99) | Mean (range) | 39.55 | NS |
Ptok et al. [25] | 2007 | 2000–2001 | RC | Multicentre (Germany) | Rectal CA | Resection | NS | 303 | 66 (32–92) | Median (range) | 32.01 | 6.6 |
Law et al. [26] | 2007 | 1996–2004 | RC | One (China) | Colorectal CA | Radical resection | Open, Lap | 1657 | 70 (24–94) | Median (range) | 43.09 | NS |
McArdle et al. [27] | 2005 | 1991–1994 | RC | Multicentre (Scotland) | Colorectal CA | Resection | NS | 2235 | NS | NS | 50.25 | NS |
Walker et al. [28] | 2004 | 1971–1999 | RC | Multicentre (Australia) | Colorectal CA | Resection | NS | 1722 | NS | NS | 5.11 | NS |
Bell et al. [29] | 2003 | 1971–1991 | RC | One (Australia) | Rectal CA | Anterior Resection | NS | 403 | 67 (31–94) | Median (range) | 29.8 | NS |
Colorectal Liver metastasis (CRLM) | ||||||||||||
Wang et al. [30] | 2022 | 2007–2018 | RC | One (China) | CRLM | Hepatectomy | Open, lap | 751 | 58 (51.0–64.0) | Median (IQR) | 35.4 | 65.8 |
Fernández-Moreno et al. [31] | 2020 | 2000–2016 | RC | One (Spain) | CRLM | Hepatectomy | Open, lap | 254 | 63.66 (±10.98) | Mean (SD) | 39.8 | NS |
Yamashita et al. [6] | 2017 | 2008–2014 | RC | One (USA) | CRLM | Hepatectomy | NS | 575 | 56 (18–88) | Median (range) | 40.7 | 86 |
Fukami et al. [32] | 2016 | 1994–2015 | RC | One (Japan) | CRLM | Hepatectomy | Open, Lap | 282 | 64 (10) | Mean (SD) | 38.65 | 6 |
Mavros et al. [33] | 2013 | 2000–2009 | RC | One (USA) | CRLM | Hepatectomy (and Radiofrequency ablation) | NS | 251 | 58 (51–68) | Median (IQR) | 34.7 | 76.9 |
Hepato-pancreatico-biliary | ||||||||||||
Neeman et al. [34] | 2019 | 2008–2016 | PC | One (Israel) | Pancreatic CA | Pancreaticoduodenectomy | NS | 148 | 66 (41–85) | Median (range) | 40 | NS |
Ma et al. [35] | 2018 | 1991–2013 | RC | One (Hong Kong) | Cholangio CA | Hepatectomy | NS | 107 | 61(25–79) | Median (range) | 45.79 | 4.67 |
Harimoto et al. [36] | 2015 | 2004–2012 | RC | Three (Japan) | Hepatocellular CA | Hepatectomy | NS | 966 | 68 | Mean | 31.6 | NS |
Chok et al. [37] | 2009 | 1989–2004 | RC | One (Hong Kong) | Hepatocellular CA | Hepatectomy | Open | 863 | 54 (12.5) | Mean (SD) | 18.42 | NS |
Peritoneal | ||||||||||||
Choudry et al. [38] | 2018 | 2001–2016 | RC | One (USA) | Peritoneal CA | CRS HIPEC | NS | 1296 | 55.8 (47.1–63.8) | Median (IQR) | NS | NS |
Schneider et al. [39] | 2017 | 2009–2014 | RC | One (Switzerland) | Peritoneal CA/metastasis | CRS HIPEC | Open, Lap | 113 | 52 (43–59) | Median (IQR) | 50.44 | NS |
Baratti et al. [40] | 2014 | 2004–2012 | RC | Two (Italy) | Peritoneal metastasis | CRS HIPEC | NS | 101 | 59.4(10.4) | Mean (SD) | 60.39 | NS |
Gastro-intestinal | ||||||||||||
Wu et al. [41] | 2019 | 2006–2016 | RC | One (China) | Gastric CA | Gastrectomy (subtotal and total) | NS | 500 | NS | NS | 36.4 | NS |
Climent et al. [42] | 2015 | 1990–2009 | RC | One (Spain) | Gastric CA | Gastric resection | NS | 271 | 69 (7) | Mean (SD) | 41 | 0 |
Urology | ||||||||||||
Notarfrancesco et al. [1] | 2023 | 2010–2020 | RC | Two (Switzerland) | Metastatic germ cell CA testis | Post-chemo RPLND | Open, lap, robotic | 136 | 31.3 (17.3–69.8) | Median (range) | NS | 100 |
Leonard et al. [43] | 2020 | 2008–2016 | RC | One (France) | Prostate CA in Renal transplant patients | Radical prostatectomy | Robotic | 27 | 63.3 [43–73] | Mean (range) | 100 | NS |
Muto et al. [44] | 2017 | 2012–2016 | RC | One (Japan) | Bladder CA | Radical Cystectomy | Robotic Open | 49 | 68.55 | Mean | 20.4 | 36.73 |
Cusano et al. [45] | 2016 | 2003–2013 | RC | One (USA) | Bladder CA | Cystectomy | Open or robotic | 213 | 67 (10.4) | Mean (SD) | 21.12 | 27.7 |
Nguyen et al. [46] | 2014 | 2001–2013 | RC | One (Switzerland) | Bladder CA | Robot assisted radical cystectomy | Robotic | 61 | 83 (80–94) | Median (range) | 11 | NS |
Tan et al. [47] | 2012 | 1995–2005 | RC | Multicentric (USA) | Renal Cell CA | Partial/radical nephrectomy | Open, Lap | 12,618 | NS | NS | 42.13 | NS |
Thoracic | ||||||||||||
Barea et al. [48] | 2021 | 2012–2014 | RC | One (Spain) | Lung cancer | Lung resection | NS | 146 | 55–78 | Range | 36.3 | NS |
Takeuchi et al. [49] | 2019 | 2000–2017 | RC | One (Japan) | Esophageal CA | Esophagectomy | NS | 431 | 64 (34–85) | Median (range) | 14.1 | NS |
Kinjo et al. [50] | 2012 | 2002–2010 | RC | One (Japan) | Esophageal CA | Esophagectomy | Thoracoscopic, open | 185 | 63.4 | Mean | 15 | NS |
Breast | ||||||||||||
Machiels et al. [51] | 2020 | 2007–2018 | RC | One (Belgium) | Breast CA | Breast Conservation Surgery + radiotherapy | NS | 763 | NS | NS | 100 | NS |
Teoh et al. [52] | 2020 | 2011–2018 | RC | One (Malaysia) | Breast CA | Mastectomy with/out reconstruction | NS | 421 | 53.16 (±10.75) | Mean (SD) | 100 | NS |
Mousa et al. [53] | 2017 | 2009–2016 | RC | One (Israel) | Breast CA | Alloplastic breast reconstruction | Open | 186 | 48.9 (21–77) | Median (range) | 100 | 13 |
Murthy et al. [54] | 2007 | 1994–2001 | RC | One (UK) | Breast CA | Mastectomy, breast conservation | Open | 1065 | 58 (22–98) | Median (range) | 100 | NS |
Sarcoma | ||||||||||||
Potkrajcic et al. [55] | 2022 | 2011–2017 | RC | One (Germany) | Soft tissue sarcoma | Excision | Open | 74 | 59.6 (18–87) | Mean (range) | 36 | 58.1 |
Broecker et al. [56] | 2017 | 2000–2015 | RC | One (USA) | Soft tissue sarcoma | Excision | Open | 546 | 55 (12–93) | Median (range) | 46 | 12 |
Head and Neck | ||||||||||||
Boukovalas et al. [57] | 2020 | 2008–2013 | RC | One (USA) | Laryngeal CA | Total laryngectomy | Open | 362 | 63.6 | Mean | 18.8 | 39.5 |
Milliet et al. [58] | 2018 | 2000–2015 | RC | One (France) | Laryngeal or hypopharyngeal CA | Total pharyngo-laryngectomy | Open | 245 | 66.4 (35–90) | Mean (range) | 11 | 48 |
Studies | Morbidity (%) | Morbidity (Grade ≥ III-%) | Classification | Commonest Surgical Complications | Follow-Up (Months) | RFS (%) | RFS (Years) | Other Oncological Outcomes | OS (%) | OS (Years) | POSTOPERATIVE COMPLICATIONS Correlation to RFS (Yes/No) | POSTOPERATIVE COMPLICATIONS Correlation to OS (Yes/No) | ||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
First (%) | Second (%) | Third (%) | Median (Range) | |||||||||||
Colorectal | ||||||||||||||
Koedam et al. [11] | 6.1 | NS | AL (NS) | NS | NS | 60 | Colon (50.9), rectal (53.6) | 5 | NA | Colon (58.5), Rectal (69.3) | 5 | Rectal-Y, Colon-N | Rectal-Y, Colon-N | |
Bao et al. [12] | 30.2 | 12.9 | CD | AL (20.3) | NS | NS | 69.5 (31.9) m(SD) | 80.7, 75.1, and 63.5 | 3, 5, and 10 | NA | 89.2, 85.3, 70.2 | 3, 5 and 10 | N | N |
Gamboa et al. [13] | 46 | 32 | CD | Infectious (20) | Intestinal dysmotility (19) | Renal (9) | 31 (IQR 13–54) | 48 | 5 | NA | 64 | 5 | Y | Y |
Fransgaard et al. [14] | 67.8 | NS | NS | NS | NS | NS | NS | NS | NS | Hazard ratios of RFS and OS calculated for delay in adjuvant therapy | NS | NS | N | N |
Wasmann et al. [3] | 35 | NS | NS | NS | NS | NS | 56 | NS | NS | 26% local recurrence | NS | NS | NS | NS |
Oh et al. [15] | NS | 37.4 | extended CD | Wound complications (31.6%) | Ileus (19.7) | AL (11.9) | 72.2 (0.2–113.6) | 81.5 | 5 | NS | NS | NS | N | NS |
Miyamoto et al. [16] | 12.6 | NS | CD | SSI (4) | AL (4) | Bowel obstruction (3) | 41.5 | 74 | 5 | NS | NS | NS | Y | Y |
Furnée et al. [17] | NS | NS | NS | AL (14.2) | NS | NS | 48 | NS | NS | RFS and OS calculated for groups with/without AL and with surgical technique | NS | NS | Y | Y |
Sprenger et al. [18] | NS | NS | NS | Wound complications (14.39) | AL (12.76) | NS | NS | 63.2 | 10 | 15.5% local recurrence | 46.6 | 10 | Y | Y |
Cienfuegos et al. [19] | NS | 5.3 | CD | NS | NS | NS | 84.8 | 68.8, 32.1 | 5,10 | NS | 48.3, 32.2 | 5, 10 | Y | Y |
Park et al. [20] | 25.51 | 16.53 | CD | AL (7.9) | Intestinal obstruction (4.66) | Anastomotic stricture | 43.6 (IQR 26–58) | 77.7 | 5 | 7.8% local recurrence | 89.2 | 5 | Y | N |
Espin et al. [21] | NS | NS | NS | AL (9.4) | NS | NS | 60 | NS | NS | 19.4% overall recurrence | 77.5 | 5 | N | N |
Krarup et al. [22] | NS | NS | NS | AL (5) | NS | NS | 63.6 (IQR 43.2–87.6) | NS | NS | 14.9% distant recurrence | NS | NS | Y | Y |
Kube et al. [23] | NS | NS | NS | AL (100) | Wound infection (2.9) | Wound dehiscence (1.2) | 23 | 63 | 5 | NS | 51 | 5 | Y | Y |
Marra et al. [24] | NS | NS | NS | Pneumonia (6.36) | UTI (6.13) | Wound infection (2.95) | 63.1 (0.3–193.6) | NS | NS | 5.7% local recurrence, 11.3% distant recurrence | 33.3 (with AL), 63.7 (without AL) | 5 | N | Y |
Ptok et al. [25] | NS | NS | NS | AL (100) | NS | NS | 40 | 70.9 | 5 | NS | NS | NS | Y | NS |
Law et al. [26] | 27.3 | NS | NS | Pulmonary (5.7) | Cardiac (5.2) | Wound (4.5) | 45.3 | NS | NS | 29.1% overall recurrence, 74.7% 5-year CSS | 64.9 | 5 | Y | Y |
McArdle et al. [27] | NS | NS | NS | AL (3.85) | NS | NS | NS | NS | NS | OS 42% in patients with AL, 55.1% in patients without AL. CSS 61% with Al, 32% without AL | NS | 5 | Y | Y |
Walker et al. [28] | NS | NS | NS | AL (5.1) | NS | NS | 129.6 (60–276) | NS | NA | OS 44.3% with AL, 64% without AL | NS | 5 | Y | Y |
Bell et al. [29] | NS | NS | NS | AL (100) | NS | NS | NA | NS | NA | 11.7% 5 year local recurrence | NS | NA | Y | NS |
Colorectal Liver metastasis | ||||||||||||||
Wang et al. [30] | 28.8 | 11.6 (CD), 19(CCI) | CD and CCI | Infection | Biliary leak | Ascites | 30 (3–154) | NS | NA | Hazard ratios calculated for different POSTOPERATIVE COMPLICATIONS grading systems | NS | NA | Y | Y |
Fernández-Moreno et al. [31] | 38.1 | NS | CD for surgical and all by CCI | NS | NS | NS | 40.5 (76–99) | 31 | 5 | NA | 62 | 5 | Y | Y |
Yamashita et al. [6] | 100 | 15 | CCI | NS | NS | NS | 37 (6.1–96) | NS | 3 | RFS calculated for both POSTOPERATIVE COMPLICATIONS group (high and low CCI) and with and without RAS mutation | NS | NS | Y | NS |
Fukami et al. [32] | 17.4 | 8.9 | CD | Wound infection (6) | Colorectal leak (2.8) | Intra-abdominal abscess (2.1) | 48 (12–192) | NS | NS | 79.5% and 57.4% 3- and 5-year OS after repeat hepatectomy | 39.5, 23.6 | 3, 5 | NS | Y |
Mavros et al. [33] | 21.91 | 5.6 | CD | Pulmonary (8) | Gastrointestinal (7.2) | Cardiac (3.6) | 33.6 (15.6–62.4) | 19.5 | 5 | NS | 41.9 | 5 | Y | Y |
Hepato-pancreato-biliary | ||||||||||||||
Neenan et al. [34] | NS | 19.59 | CD | Pancreatic fistula (8.1) | Major wound complications (4.73) | Hemorrhage (2.7) | 22 (2–102) | 15.5 | 3 | NS | 20 | 5 | N | N |
Ma et al. [35] | 32.7 | 20.6 | CD | Pleural effusion (15.88) | Pneumonia (8.4) | Liver or renal failure (6.5 each) | 24 (3.19–276.27) | 27 | 3 | NS | 27 | 5 | Y | Y |
Harimoto et al. [36] | NS | 17.1 | CD | Bile leak (3.4) | Wound infection (3) | Abdominal abscess (2.9) | 40.8 | 23.7 | 5 | NS | 48.6 | 5 | Y | Y |
Chok et al. [37] | 33.4 | NS | NS | Wound complications (9.7) | Pulmonary (8) | Liver failure (5) | 35.6 | NS | NS | NS | 41.5, 26.6 | 5, 10 | N | Y |
Peritoneal | ||||||||||||||
Choudry et al. [38] | 66 | 24 | CD, CCI | NS | NS | NS | 55 | 14 | 5 | NS | 39 | 5 | NS | NS |
Schneider et al. [39] | 41.7 | 10.6 | CD | NS | NS | NS | 28 | NS | 3 | 26, 38, 96% 3-year RFS colorectal, high grade appendiceal, and low grade appendiceal CA | NS | NS | Y | NS |
Baratti et al. [40] | NS | 23.8 | NCI-CTCAE | AL/perforation (6.93) | Hematological toxicity (5.94) | Abdominal abscess (4.95) | 44.9 (24.1–65.7) | 14.3 | 5 | NS | 11.7 | 5 | Y | Y |
Gastro-intestinal | ||||||||||||||
Wu et al. [41] | 26.5 | 19.1 | NS | Surgical (20.5) | General (19.1) | Infectious (14.8) | 25.7 (12.3–48) | 53.6 | 3 | NS | 63.4 | 3 | Y | N |
Climent et al. [42] | 59.8 | 10 | CD, CCI | Intraabdominal sepsis (13.6) | Respiratory sepsis (7) | CLABSI (5.2) | 149.9 (140.1–159.9) | NS | NS | NS | 55.8, 48.1 | 5, 10 | N | N |
Urology | ||||||||||||||
Notarfrancesco et al. [1] | 30.9 | 9.55 | CD | Ileus | Circulatory | Pulmonary | 37.2 (0.1–142.1) | 20.6 | 5 | 41.3% local recurrence, 58.6% distant recurrence or tumor marker positive | 90.45 | 5 | N | N |
Leonard et al. [43] | 29.6 | 7.4 | CD | NS | NS | NS | 34.9 | NS | NS | RFS 26.9 months in transplant patients | NS | NS | NS | NS |
Muto et al. [44] | NS | NS | NS | Pyelonephritis (10.2) | Neobladder stenosis (4.08) | Rectal injury (4.08) | 21.75 (7–32) | NS | NS | mean: RFS, 37.4 months; OS, 40.2 months | NS | NS | NS | NS |
Cusano et al. [45] | NS | 19.24 | CD | Gastrointestinal (22.07) | Vascular (14.55) | Infection (13.14) | NS | NS | NS | 22.3% vs. 34.8% recurrence in robotic vs. open surgery | NS | NS | NS | NS |
Nguyen et al. [46] | 44 | 14.75 | CD | Infectious (38) | Gastrointestinal | Cardiac | 36 | 73 | 2 | NS | 61 | 2 | NS | NS |
Tan et al. [47] | 37 | NS | NS | Gastrointestinal (12.4) | Pulmonary failure(7.5) | Genitourinary(6.4) | 32 (1–132) | NS | NS | NS | 59.9 | 5 | NS | Y |
Thoracic | ||||||||||||||
Barea et al. [48] | 46.6 | 11.6 | CD | Atelectasis with bronchoscopy | Bleeding | Empyema | 48 | NS | NS | NS | 64.7 | 2 | Y | Y |
Takeuchi et al. [49] | 71.3 | NS | CD | RLN palsy (26.4) | Pneumonia (19.7) | AL (15.8) | NS | 59 | 3 | NS | 69.5 | 3 | NS | NS |
Kinjo et al. [50] | 58.38 | NS | NCI-CTCAE | Pulmonary (28.65) | Recurrent Laryngeal Nerve palsy (16.76) | Anastomotic leak (12.97) | 33.33 (3–95) | NS | 2 | 71.6%, 57.7%, and 58.3% RFS, in thoracoscopic-lap group, thoracoscopic and open groups | NS | NS | N | NS |
Breast | ||||||||||||||
Machiels et al. [51] | 3.5 | NS | NS | Hematoma (2.6) | Wound infection (0.66) | Wound dehiscence (0.26) | 62.2 (0.5–135) | 95.1 | 5 | NA | 97.2 | 5 | Y | Y |
Teoh et al. [52] | NS | NS | NS | Seroma(13) | SSI (7.8) | Bleeding/Hematoma (4.7) | 44 | NS | NS | 8.3% local and 12.8% Distant recurrence | NS | NS | NS | NS |
Mousa et al. [53] | 45 | NS | NS | Dehiscence or infectious (16) | Skin necrosis (10) | Hematoma (4) | 40.28 | NS | NS | (4%)Local or regional, (7%)Distant recurrence, (3%) both | NS | NS | N | NS |
Murthy et al. [54] | NS | NS | NS | Wound complications (9) | NS | NS | NS | 82.2 | 5 | NA | NS | NS | Y | NS |
Soft tissue Sarcoma | ||||||||||||||
Potkrajcic et al. [55] | NS | NS | MWC scoring | Wound complications | NS | NS | 57.96 (74.4) | 77.4 | 5 | NS | 91.9 | 5 | NS | NS |
Broecker et al. [56] | 29 | 16 | CD | NS | NS | NS | 37 (0–185) | 40 | 5 | 35% recurrence (39% local and 61% distant) | NS | NS | Y | NS |
Head and Neck | ||||||||||||||
Boukovalas et al. [57] | 37.6 | 25.4 | CD | Wound complications (22.1) | Pneumonia (5.8) | Total flap loss (2.3) | 21.1 (0.2–132.9) | NS | NA | 29% local, 29% distant recurrence | NS | NS | Y | Y |
Milliet et al. [58] | NS | NS | NS | Salivary fistula (31.43) | NS | NS | NS | 31 | 5 | NS | 36 | 5 | NS | NS |
Studies | Data Duration | Publication Year | Cancer Diagnosis | Studies | Sample Size | RFS [Pooled HR (95% CI)] | OS [Pooled HR (95% CI)] | Other Oncological Outcomes | RFS/OS (Year) | POSTOPERATIVE COMPLICATIONS Impact on RFS | POSTOPERATIVE COMPLICATIONS Impact on OS |
---|---|---|---|---|---|---|---|---|---|---|---|
Mualla et al. [60] | NS | 2021 | Non-metastatic Colorectal CA | 16 (1 RCT, 3 PC, 12 RC) | 37,192 | 1.41 (1.11–1.80) | 1.36 (1.15–1.61) | NS | NS | Y | Y |
Kong et al. [61] | 2000–2019 | 2021 | Hepatocellular Carcinoma | 37 (RC) | 14,096 | 1.25 (1.16–1.35) | 1.39 (1.28–1.5) | NS | 5 | Y | Y |
Chen et al. [62] | 2009–2020 | 2021 | Gastric CA | 32 (RC) | 32,067 | 1.49 (1.33–1.67) | NS | NS | NS | Y | Y |
Li et al. [59] | 1998–2018 | 2020 | Gastric CA | 64 (49 RC, 15 PC) | 46,198 | 1.66 (1.13–2.44) | 1.58 (1.37–1.82) | NS | NS | Y | Y |
Dorcaratto et al. [63] | NS | 2019 | Colorectal Liver metastasis | 41 | 12,817 | 1.38 (1.27–1.49) | 1.43 [1.3–1.57] | NS | 5 | Y | Y |
Wang et al. [64] | 1986–2015 | 2019 | Gastric CA | 16 (RC) | 12,065 | 1.28 (1.10–1.49) | 1.40 (1.06–1.84) | NS | NS | Y | Y |
Lu et al. [65] | 1982–2015 | 2016 | Rectal cancer | 11 (5 PC, 6 RC) | 13,655 | NS | NS | 1.61 (1.25–2.09) Local recurrence | NS | Y | Y |
Yin et al. [66] | 1991–2007 | 2015 | Colorectal Liver metastasis | 5 (4 PC, 1 RC) | 2370 | 1.37 (1.23–1.53); 1.34 (1.17–1.53) | 1.52 (1.27–1.83); 1.36 (1.18–1.58) | NS | 5; 10 | Y | Y |
Mirnezami et al. [67] | 1965–2009 | 2011 | Colorectal CA | 21 (1 RCT, 13 non RCT, 7 RC) | 21,902 | NS | 1.64 (1.4–1.91) | 2.05 (1.51–2.8) Local recurrence | NS | Y | Y |
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Wajekar, A.; Solanki, S.L.; Cata, J.; Gottumukkala, V. Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence? Curr. Oncol. 2024, 31, 4632-4655. https://doi.org/10.3390/curroncol31080346
Wajekar A, Solanki SL, Cata J, Gottumukkala V. Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence? Current Oncology. 2024; 31(8):4632-4655. https://doi.org/10.3390/curroncol31080346
Chicago/Turabian StyleWajekar, Anjana, Sohan Lal Solanki, Juan Cata, and Vijaya Gottumukkala. 2024. "Postoperative Complications Result in Poor Oncological Outcomes: What Is the Evidence?" Current Oncology 31, no. 8: 4632-4655. https://doi.org/10.3390/curroncol31080346