Erschienen in:
10.07.2018 | Original Article
Postoperative Infectious Complications Impact Long-Term Survival in Patients Who Underwent Hepatectomies for Colorectal Liver Metastases: a Propensity Score Matching Analysis
verfasst von:
Riccardo Memeo, Vito de Blasi, Rene Adam, Diane Goéré, Alexis Laurent, Nicola de’Angelis, Tullio Piardi, Emilie Lermite, Astrid Herrero, Francis Navarro, Antonio Sa Cunha, Patrick Pessaux, on behalf of the French colorectal liver metastases working group - Association Française de Chirurgie (AFC)
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 12/2018
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Abstract
Objective
Postoperative complications strongly impact the postoperative course and long-term outcome of patients who underwent liver resection for colorectal liver metastases (CRLM). Among them, infectious complications play a relevant role. The aim of this study was to evaluate if infectious complications still impact overall and disease-free survival after liver resection for CRLM once patients were matched with a propensity score matching analysis based on Fong’s criteria.
Methods
A total of 2281 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched with a 1:3 propensity score analysis in order to compare patients with (INF+) and without (INF−) postoperative infectious complications.
Results
Major resection (OR = 1.69 (1.01–2.89), p = 0.05) and operative time (OR = 1.1 (1.1–1.3), p = 0.05) were identified as risk factors of infectious complications. After propensity score matching, infectious complications are associated with overall survival (OS), with 1-, 3-, 5-year OS at 94, 81, and 66% in INF− and 92, 66, and 57% in INF+ respectively (p = 0.01). Disease-free survival (DFS) was also different with regard to 1-, 3-, 5-year survival at 65, 41, and 22% in R0 vs. 50, 28, and 17% in INF+ (p = 0.007).
Conclusion
Infectious complications are associated with decreased overall and disease-free survival rates.