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開催概要
開催回
第58回・2020年・京都
 

当院における大腸癌術後合併症の長期予後に与える影響

演題番号 : WS18-5

[筆頭演者]
茂田 浩平:1 
[共同演者]
岡林 剛史:1、清島 亮:1、松井 信平:1、加藤 悠人:1、北川 雄光:1

1:慶應義塾大学・一般・消化器外科

 

Background: The prevention of postoperative complications is essential for patient safety. However, the occurrence of postoperative complications is known to affect long-term survival of patients with colorectal cancer. In this study, we assessed the relationship between the postoperative complications and long-term survival of patients with colorectal cancer.
Methods: Data pertaining to the patients who underwent curative resection of colorectal cancer at our institution between 2012 and 2019 were retrospectively analyzed. The severity and management of complications were categorized using the Clavien-Dindo (CD) scale. Furthermore, Cox regression analysis was performed to assess the correlation between clinicopathological variables and long-term outcomes.
Results: A total of 782 patients (427 males and 355 females) were enrolled in this study, including 297 stage I patients, 238 stage II patients, and 247 stage III patients. The mean age of the patients was 68.0 ± 12.7 years; the mean follow-up period was 35.4 ± 23.0 months. Postoperative complications occurred in 161 patients (CD grade 1, 48; grade 2, 84; grade 3a, 12; grade 3b, 10; grade 4, 5; and grade 5, 2). Recurrence was observed in 86 patients; 64 patients died during the follow-up period. Multivariate analysis revealed that the CD grade was an independent predictor of overall survival (OS) [Hazard ratio (HR) 1.32, 95% confidence interval 1.08-1.61, p = 0.007]. However, the CD grade showed no significant association with relapse-free survival. Furthermore, we divided the patients with complications into two subgroups: CD grade 1 and CD grade >2. The OS in both CD grade 1 (HR 2.50, p = 0.042) and CD grade >2 (HR 1.93, p = 0.034) groups was significantly shorter than that of the patients without complications.
Conclusion: Postoperative complication is a strong predictor of OS in patients with colorectal cancer. Moreover, postoperative complication affects the OS even in patients with CD grade 1 colorectal cancer.

キーワード

臓器別:大腸・小腸

手法別:手術療法

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