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The Impact of Postoperative Complications on Long-term Oncologic Outcomes After Laparoscopic Low Anterior Resection for Rectal Cancer.

Authors
 Eun Jung Park  ;  Seung Hyuk Baik  ;  Jeonghyun Kang  ;  Hyuk Hur  ;  Byung Soh Min  ;  Kang Young Lee  ;  Nam Kyu Kim 
Citation
 MEDICINE, Vol.95(14) : 3271, 2016 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Aged ; Aged, 80 and over ; Digestive System Surgical Procedures/methods ; Disease-Free Survival ; Female ; Humans ; Laparoscopy* ; Male ; Middle Aged ; Postoperative Complications/epidemiology* ; Rectal Neoplasms/mortality ; Rectal Neoplasms/surgery* ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome
Abstract
Laparoscopic rectal cancer surgery has technical difficulties with a higher complication rate than colon cancer. However, few studies have examined whether postoperative complications are associated with oncologic outcomes. The aim of this study is to evaluate the impact of postoperative complications on long-term oncologic outcomes after laparoscopic low anterior resection for rectal cancer.Between January 2005 and December 2012, we evaluated 686 consecutive patients who underwent laparoscopic low anterior resection for stage I-III rectal cancer. Patients were divided into complication (n = 175) and noncomplication (n = 511) groups. The median follow-up period was 38 months (range, 2-118). We compared perioperative clinicopathologic outcomes, 5-year survival, and local recurrence between groups and evaluated prognostic factors.Five-year overall survival rates were 91.4% and 89.2% (P = 0.234) and 5-year disease-free survival rates were 83.2% and 77.7% (P = 0.002) in the noncomplication and complication groups for all stages, respectively. For stage I cancer, both the 5-year overall survival and the 5-year disease-free survival rate of the complication group were lower than the noncomplication group. Local recurrence rates were 3.1% and 7.8% in the noncomplication and complication groups, respectively (P = 0.002). In multivariate analysis, the presence of postoperative complications was a significant predictor of 5-year disease-free survival (hazard ratio, 1.65; P = 0.012).Postoperative complications had a negative impact on 5-year disease-free survival after laparoscopic low anterior resection for rectal cancer. The rate of local recurrence in the complication group increased more than the noncomplication group. In particular, postoperative complications were associated with poorer oncologic outcomes for stage I cancer. Laparoscopic surgery is preferred for early-stage rectal cancer so careful attention should be paid to avoid postoperative complications.
Files in This Item:
T201602231.pdf Download
DOI
10.1097/MD.0000000000003271
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Lee, Kang Young(이강영)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147205
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