title: Prognostic significance of complications after laparoscopic colectomy for colon cancer.
abstract: OBJECTIVE
  This study sought to evaluate the prognostic significance of postoperative complications for colon cancer patients undergoing laparoscopic surgery.
  
  
  METHODS
  From May 2006 to May 2009, a total 224 patients who underwent laparoscopic curative resection (R0) for colon cancer were included in our retrospective study. Postoperative complications were evaluated according to a standardized grading system. The main outcome measurements of our study were overall survival (OS) and relapse-free survival (RFS), which were then compared between the no complication and complication groups. Univariate and multivariate analysis were used to assess the correlation between complications and prognosis.
  
  
  RESULTS
  Fifty-nine postoperative complications occurred in 43 patients. The overall morbidity rate was 26.3%. The 5-year OS in the complication group was 41.4% compared with 78.5% in the no complication group (P<0.001). The cumulative incidence of relapse was also more aggressive in patients with complications (5-year RFS: complication group 40.9% vs. no complication group 82.1%, P<0.001). Multivariate analysis identified complications as a significant factor increasing the risk for both OS (RR 2.737; 95% CI 1.512-4.952; P = 0.001) and RFS (RR 4.247; 95% CI 2.291-7.876; P<0.001).
  
  
  CONCLUSIONS
  Postoperative complications could pose a significant adverse impact not only on OS but also on RFS in patients with colon cancer even when laparoscopic R0 resection is available.
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Xia
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Kundong
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Gang
authors.initials: G
authors.lastname: Cen
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Kejian
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Shanghai Jiaotong University Affiliated First People's Hospital, Shanghai, People's Republic of China.
authors.forename: Zhengjun
authors.initials: Z
authors.lastname: Qiu
mesh_terms: D000368:Aged; D003082:Colectomy / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome