title: Impact of Postoperative Morbidity on Long-Term Survival After Resection for Colorectal Liver Metastases.
abstract: Although correlation of postoperative morbidity with long-term survival is recognized to influence long-term survival after other cancer surgery, little information exists about the impact of postoperative morbidity on patient outcomes following liver resection for colorectal metastases.
  
  
  
  We studied the impact of postoperative morbidity on long-term survival after liver resection for colorectal cancer metastases using data from 312 patients with curative hepatectomy.
  
  
  
  Among all 312 patients evaluated, 98 complications occurred, affecting 80 patients (26%). The 80 patients with morbidity had a lower disease-free rate (P = 0.03), resulting in poor overall survival (P = 0.02) compared with the group with no morbidity (n = 232). Decreases in disease-free and overall survival also were associated with severity of postoperative complications. When patients were divided according to extent of metastases, little impact of morbidity on overall survival (P = 0.10) and disease-free rate (P = 0.35) was demonstrated in patients whose metastases were less advanced. However, a negative impact of morbidity compared with no morbidity on disease-free rate (P < 0.01) and overall survival (P < 0.01) was confirmed in patients with aggressive or advanced metastases.
  
  
  
  Postoperative morbidity had a negative impact on long-term survival, especially for aggressive or advanced metastases or severe complications.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. ktrj112@urahp.yokohama-cu.ac.jp.
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kumamoto
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nojiri
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Ryusei
authors.initials: R
authors.lastname: Matsuyama
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D047368:Tumor Burden