title: Complications following liver resection for colorectal metastases do not impact on longterm outcome.
abstract: BACKGROUND
  It has been suggested that adverse postoperative outcomes may have a negative impact on longterm survival in patients with colorectal liver metastases.
  
  
  OBJECTIVE
  This study was conducted to evaluate the prognostic impact of postoperative complications in patients submitted to a potentially curative resection of colorectal liver metastases.
  
  
  METHODS
  A retrospective analysis of outcomes in 199 patients submitted to hepatic resection with curative intent for metastatic colorectal cancer during 1999-2008 was conducted.
  
  
  RESULTS
  The overall complication rate was 38% (n = 75). Of all complications, 79% were minor (Grades I or II). There were five deaths (3%). The median length of follow-up was 39 months. Rates of 5-year overall and disease-free survival were 44% and 27%, respectively. Univariate analysis demonstrated that an elevated preoperative level of carcinoembryonic antigen (CEA), intraoperative blood loss of > 300 ml, multiple metastases, large (≥ 35 mm) metastases and resection margins of < 1 mm were associated with poor overall and disease-free survival. In addition, male sex and synchronous metastases were associated with poor disease-free survival. Postoperative complications did not have an impact on either survival measure. The multivariate model did not include complications as a predictive factor.
  
  
  CONCLUSIONS
  Postoperative complications were not found to influence overall or disease-free survival in the present series. The number and size of liver metastases were confirmed as significant prognostic factors.
authors.affiliation: Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, North Shore Private Hospital, St Leonards, NSW, Australia; Discipline of Surgery, University of Sydney, Sydney, NSW, Australia.
authors.forename: Tony C
authors.initials: TC
authors.lastname: Pang
authors.forename: Calista
authors.initials: C
authors.lastname: Spiro
authors.forename: Tim
authors.initials: T
authors.lastname: Ramacciotti
authors.forename: Julian
authors.initials: J
authors.lastname: Choi
authors.forename: Martin
authors.initials: M
authors.lastname: Drummond
authors.forename: Edmund
authors.initials: E
authors.lastname: Sweeney
authors.forename: Jaswinder S
authors.initials: JS
authors.lastname: Samra
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Hugh
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology; D012189:Retrospective Studies