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首页> 外文期刊>Annals of Surgery >Impact of postoperative complications on survival and recurrence after resection of colorectal liver metastases: Systematic review and meta-analysis
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Impact of postoperative complications on survival and recurrence after resection of colorectal liver metastases: Systematic review and meta-analysis

机译：切除结直肠肝转移后术后并发症对术后并发症的影响：系统审查和荟萃分析

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Objective: To study the effect of postoperative complications (POC) on overall survival (OS) and disease-free survival (DFS) after surgical resection of colorectal liver metastases (CRLM). Summary Background Data: Morbidity rates after liver resection can reach 45%. The negative impact of POC on oncologic outcomes has been reported in various types of cancer, especially colorectal. However, data on the consequences of POC after CRLM resection on long-term survival are scarce. Methods: Eligible studies examining the association between POC after CRLM resection and OS/DFS were sought using the PubMed and Web of Science databases. A random-effects model was used to calculate pooled effect estimate for OS and DFS hazard ratios (HR), estimating between-study variance with restricted maximum likelihood estimator with HartungKnapp adjustment. Subgroup analysis was used to control the effect of POC on OS and DFS for: 1) Method used to define postoperative complications, 2) Exclusion of early postoperative death from survival analysis, 3) Method of data extraction used, and 4) Tumor and treatment characteristics. Results: Forty-one studies were deemed eligible, including 12,817 patients. POC patients had a significant risk of reduced OS compared with no POC group (HR 1.43 [95% CI: 1.3, 1.57], P < 0.0001). POC had also a negative impact on DFS. The HR for reduced DFS was 1.38 [95% CI 1.27, 1.49], P < 0.0001. The negative impact of POC on survival and recurrence was confirmed in subgroup analysis. Conclusions: Our findings evidence the negative impact of POC on survival and recurrence after CRLM resection.
机译：目的：探讨术后并发症（POC）对结直肠肝转移（CRLM）外科切除后整体存活（OS）和无病生存（DFS）的影响。摘要背景数据：肝切除后的发病率可达45％。 PoC对各种类型的癌症，尤其是结直肠癌的肿瘤结果的负面影响。但是，在长期生存率上CRLM切除后POC后果的数据是稀缺的。方法：使用科学数据库的PubMed和Web寻找CRLM切除和OS / DFS后，符合条件的研究审查POC之间的关联。随机效应模型用于计算OS和DFS危险比（HR）的汇总效应估计，估计与Hartungknapp调整的受限最大似然估计的研究关系。亚组分析用于控制POC对OS和DFS的影响：1）方法用于定义术后并发症，2）从存活分析中排除早期术后死亡，3）使用的数据提取方法和4）肿瘤和治疗方法特征。结果：认为符合要求的四十一项研究，包括12,817名患者。与NO POC组（HR 1.43 [95％CI：1.3,1.57]，P <0.0001）相比，POC患者的风险显着降低了OS（HR 1.43 [95％：1.3,1.57]。 POC对DFS也存在负面影响。降低DFS的HR为1.38 [95％CI 1.27,1.49]，P <0.0001。在亚组分析中证实了POC对存活和复发的负面影响。结论：我们的调查结果证明了PoC对CRLM切除后PoC对存活和复发的负面影响。

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