title: Impact of postoperative complications on long-term survival after resection for rectal cancer.
abstract: BACKGROUND
  The relevance of type and severity of postoperative complications after curative resection for rectal cancer on survival and recurrence rates is a matter of controversy.
  
  
  OBJECTIVE
  The aim of this study was to investigate the impact of postoperative complications on long-term outcome after resection for rectal cancer.
  
  
  METHODS
  This study is a retrospective analysis of prospectively collected data.
  
  
  METHODS
  The study was conducted at a university teaching hospital by a specialized colorectal team.
  
  
  METHODS
  Between January 1984 and October 2008, 811 patients with rectal cancer underwent curative resection. Patients who experienced postoperative complications were divided into a minor complication group (grades I and II) and a major complications group (grades III and IV) according to the Clavien classification.
  
  
  METHODS
  The influence of several pathological and clinical factors, including complications in terms of overall and disease-free survival, was tested and compared in univariate and multivariate analyses.
  
  
  RESULTS
  Curative resection was performed in 811 patients; median age was 65 years. The Kaplan-Meier estimates (± SE) for 5- and 10-year overall cumulative survival were 70.3% ± 1.8% and 54.5% ± 2.4%; Kaplan-Meier estimates for 5- and 10-year disease-free survival were 64.0% ± 1.8% and 50.9% ± 2.3%. One hundred sixty-five patients (20.3%) had minor complications, and 103 patients (12.7%) had major complications. Twelve patients (1.48%) died within 30 days after surgery. There was no significant difference between patients with no complications, patients with minor complications, and patients with major complications in terms of overall (p = 0.41) or disease-free survival (p = 0.32).
  
  
  CONCLUSIONS
  A possible limitation of our study is that the data represent a cohort study from a single center.
  
  
  CONCLUSIONS
  Following resection for rectal cancer, the severity of postoperative complications (minor or major) according to a standardized classification system does not demonstrate a statistically significant effect on either overall or disease-free survival.
authors.affiliation: Department of Surgery, Hospital of the Brothers of Mercy, St. Veit/Glan, Austria.
authors.forename: Karl
authors.initials: K
authors.lastname: Mrak
authors.forename: Thomas
authors.initials: T
authors.lastname: Eberl
authors.forename: Andreas
authors.initials: A
authors.lastname: Laske
authors.forename: Michael
authors.initials: M
authors.lastname: Jagoditsch
authors.forename: Josef
authors.initials: J
authors.lastname: Fritz
authors.forename: Jörg
authors.initials: J
authors.lastname: Tschmelitsch
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology; D001317:Austria / Q000453:epidemiology; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D018572:Disease-Free Survival; D004210:Dissection / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index