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Meta-Analysis
. 2021 Jun 9;19(1):167.
doi: 10.1186/s12957-021-02267-6.

Does liver cirrhosis affect the surgical outcome of primary colorectal cancer surgery? A meta-analysis

Yu-Xi Cheng #  1 , Wei Tao #  1 , Hua Zhang  1 , Dong Peng  2 , Zheng-Qiang Wei  1
Affiliations
Meta-Analysis

Does liver cirrhosis affect the surgical outcome of primary colorectal cancer surgery? A meta-analysis

Yu-Xi Cheng et al. World J Surg Oncol. .

Abstract

Purpose: The purpose of this meta-analysis was to evaluate the effect of liver cirrhosis (LC) on the short-term and long-term surgical outcomes of colorectal cancer (CRC).

Methods: The PubMed, Embase, and Cochrane Library databases were searched from inception to March 23, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of enrolled studies, and RevMan 5.3 was used for data analysis in this meta-analysis. The registration ID of this current meta-analysis on PROSPERO is CRD42021238042.

Results: In total, five studies with 2485 patients were included in this meta-analysis. For the baseline information, no significant differences in age, sex, tumor location, or tumor T staging were noted. Regarding short-term outcomes, the cirrhotic group had more major complications (OR=5.15, 95% CI=1.62 to 16.37, p=0.005), a higher re-operation rate (OR=2.04, 95% CI=1.07 to 3.88, p=0.03), and a higher short-term mortality rate (OR=2.85, 95% CI=1.93 to 4.20, p<0.00001) than the non-cirrhotic group. However, no significant differences in minor complications (OR=1.54, 95% CI=0.78 to 3.02, p=0.21) or the rate of intensive care unit (ICU) admission (OR=0.76, 95% CI=0.10 to 5.99, p=0.80) were noted between the two groups. Moreover, the non-cirrhotic group exhibited a longer survival time than the cirrhotic group (HR=2.96, 95% CI=2.28 to 3.85, p<0.00001).

Conclusion: Preexisting LC was associated with an increased postoperative major complication rate, a higher rate of re-operation, a higher short-term mortality rate, and poor overall survival following CRC surgery.

Keywords: Colorectal cancer; Liver cirrhosis; Meta-analysis; Surgical outcome.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of study selection
Fig. 2
Fig. 2
Forest plot showing the short-term outcomes. a Minor complications, b major complications, c postoperative ICU admission, and d Reoperation rate
Fig. 3
Fig. 3
Forest plot showing the short-term mortality rate
Fig. 4
Fig. 4
Forest plot showing the long-term survival
Fig. 5
Fig. 5
Funnel plot showing the short-term mortality rate
See this image and copyright information in PMC

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