title: Perioperative morbidity affects long-term survival in patients following liver resection for colorectal metastases.
abstract: BACKGROUND
  Hepatic resection is the treatment of choice in patients with colorectal liver metastases. Perioperative morbidity is associated with decreased long-term survival in several cancers. The aim of this study was to assess the impact of perioperative morbidity and other prognostic factors on the outcome of patients undergoing liver resection for colorectal metastases.
  
  
  METHODS
  One hundred ninety seven patients undergoing liver resection with curative intent were investigated. The influence of prognostic factors, such as complications, tumor stage, margins, age, sex, number of lesions, transfusion, portal inflow obstruction, and era and type of resection, was assessed using univariate and multivariate analysis. Complications were graded using an objective surgical complication classification.
  
  
  RESULTS
  The 5-year survival rate was 38%, with a median follow up of 4.5 years. The disease-free survival rate at 5 years was 23%. The perioperative morbidity and mortality rates were 30 and 2.5%, respectively. The median survival of patients with perioperative complications was 3.2 years, compared to 4.4 years in those patients without complications (p < 0.01). For patients with positive resection margins, the median survival was 2.1 years, compared 4.4 years in patients with a margin (p = 0.019).
  
  
  CONCLUSIONS
  Perioperative morbidity and a positive resection margin had a negative impact on long-term survival in patients following liver resection for colorectal metastases.
authors: Department of Visceral and Transplantation Surgery, University Hospital of Zurich, Zurich, Switzerland.
authors: M
authors: M
authors: Schiesser
authors: J W C
authors: JW
authors: Chen
authors: G J
authors: GJ
authors: Maddern
authors: R T A
authors: RT
authors: Padbury
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013021:South Australia / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors