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Review
. 2017 Apr 25;1(1):11-23.
doi: 10.1002/ags3.12002. eCollection 2017 Apr.

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Hideaki Shimada  1 , Takeo Fukagawa  2 , Yoshio Haga  3   4 , Koji Oba  5   6
Affiliations
Review

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Hideaki Shimada et al. Ann Gastroenterol Surg. .

Abstract

Purpose: The impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.

Methods: A literature search of PubMed/MEDLINE was performed using the keywords "esophageal cancer," "gastric cancer," and "colorectal cancer," obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.

Results: Patients with postoperative complications had significantly poorer long-term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31-2.12), 1.59 (95% CI, 1.13-2.24), and 1.55 (95% CI, 1.28-1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.

Conclusions: Complications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

Keywords: colorectal cancer; esophageal cancer; gastric cancer; oncological outcome; postoperative complication.

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Figures

Figure 1
Figure 1
Postoperative morbidity and long‐term survival after radical surgery for esophageal cancer. BMI, body mass index.
Figure 2
Figure 2
Postoperative morbidity and long‐term survival after radical surgery for gastric cancer.
Figure 3
Figure 3
Postoperative morbidity and long‐term survival after radical surgery for colorectal cancer
Figure 4
Figure 4
Relationship between postoperative complications and long‐term survival following gastrointestinal cancer resection
See this image and copyright information in PMC

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