title: Does postoperative complication have a negative impact on long-term outcomes following hepatic resection for colorectal liver metastasis?: a meta-analysis.
abstract: BACKGROUND
  The negative impact of postoperative complications (POCs) on long-term outcomes is well documented for several cancer surgeries, but conclusive evidence has yet to be provided on the influence of POCs on long-term oncological outcomes after hepatic resection for colorectal liver metastasis (CRLM).
  
  
  METHODS
  Studies published through February 2012 evaluating the oncological impact of POCs after hepatectomy for CRLM were identified by an electronic literature search. Finally, 4 studies were identified and included in the meta-analysis. The main outcome measures were 5-year disease-free survival (DFS) and overall survival (OS). A meta-analysis was performed using the DerSimonian-Laird random-effects models to compute odds ratio (OR) along with 95 % confidence intervals (95 % CI).
  
  
  RESULTS
  The outcomes of 2,280 patients were studied. Meta-analysis of 5-year DFS data extracted from three studies demonstrated a significant reduction in 5-year DFS after POCs, with an OR of 1.98 (95 % CI = 1.33-2.96; P = .0008). Meta-analysis of 5-year OS data extracted from four studies demonstrated a significant reduction in 5-year OS after POCs, with an OR of 1.68 (95 % CI = 1.25-2.27; P = .0006). No differences between study heterogeneity were observed in either the DFS or the OS analyses.
  
  
  CONCLUSIONS
  This study provides persuasive evidence that POCs following hepatic resection for CRLM have significant adverse oncological outcomes. These findings emphasize the need for meticulous surgical technique and careful perioperative management to minimize POCs.
authors.affiliation: Department of Surgery, Nippon Medical School Chiba-Hokuso Hospital, Chiba, Japan. a-matsu@nms.ac.jp
authors.forename: Akihisa
authors.initials: A
authors.lastname: Matsuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Seya
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsutani
authors.forename: Taro
authors.initials: T
authors.lastname: Kishi
authors.forename: Kimiyoshi
authors.initials: K
authors.lastname: Yokoi
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D016001:Confidence Intervals; D018572:Disease-Free Survival; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D016017:Odds Ratio; D015996:Survival Rate; D013997:Time Factors