6533b7d1fe1ef96bd125d6e7

RESEARCH PRODUCT

Impact of perioperative transfusions and sepsis on long-term oncologic outcomes after curative colon cancer resection. A retrospective analysis of a prospective database

Javier EscrigAlejandro EspíSusana RosellóEduardo García-graneroÁLvaro García-graneroGloria BaguenaGianluca PellinoMatteo FrassonFranco G. MarinelloAndrés Cervantes

subject

Malemedicine.medical_specialtyTime FactorsDatabases FactualSurvivalSepsiColorectal cancer030230 surgerycomputer.software_genre03 medical and health sciencesPostoperative Complications0302 clinical medicineSeptic complicationSepsisLocal recurrencemedicineHumansAnastomotic leakPerioperative PeriodAgedRetrospective StudiesAged 80 and overHepatologyDatabaseProportional hazards modelbusiness.industryMortality rateBlood transfusionHazard ratioGastroenterologyPerioperativeMiddle Agedmedicine.diseaseColorectal surgeryColon cancerSurvival RateBowel obstructionTreatment OutcomeAnastomotic leak Blood transfusion Colon cancer Complicaciones sépticas Complicación Complication Cáncer de colon Fuga anastomótica Local recurrence Recurrencia local Sepsis Septic complications Supervivencia Survival Transfusión de sangre030220 oncology & carcinogenesisColonic NeoplasmsFemaleComplicationbusinessComplicationcomputerSeptic complications

description

Objective: Intra-abdominal septic complications (IASC) affect short-term outcomes after surgery for colon cancer. Blood transfusions have been associated with worse short-term results.The role of IASC and blood transfusions on long-term oncologic results is still debated. This study aims to assess the impact of these two variables on survival after curative colon cancer resection. Patients and methods: Retrospective analysis of a prospectively maintained database of patients who underwent curative surgery for colon cancer at a university hospital, between 1993 and 2010. Cox regression was used to identify the role of IASC and transfusions (alone and combined) on local recurrence (LR), disease-free survival (DES), and cancer-specific survival (CSS). Results: Out of the 1686 patients analyzed, 1277 fit in the inclusion criteria. Colorectal surgeons performed the procedure in 82.2% of the patients. Blood transfusions were administered to 25.8% of the patients. Thirty-day complication and mortality rates were 34.5% and 6.1%. IASC occurred in 9.9%. The mean follow-up was 66 months. The 5-year rates of LR, DES, and CSS were 7%, 79.8%, and 85.1%. The year of surgery and pT (Hazard ratio 9.35, 95% CI 1.23-70.9, for T4) and pN (Hazard ratio 2.57, 95% CI 1.39-4.72, for N2) stages were independent risk factors for LR. The same variables, bowel obstruction and surgeries performed by surgeons not specialized in colorectal surgery, were also associated with worse DES and CSS. IASC and blood transfusions were not associated with LR, DFS, and CSS, whether alone or combined. Conclusions: IASC and transfusions were not associated with worse oncological outcomes after curative colon cancer surgery per se. Other factors were more important predictors of survival. (C) 2019 Published by Elsevier Espana, S.L.U.

yearjournalcountryeditionlanguage
2020-02-01Gastroenterología y Hepatología
https://doi.org/10.1016/j.gastrohep.2019.07.005