Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria.
OBJECTIVE
Prior to publication of the Clavien-Dindo classification in 2004, there were no grading definitions for surgical complications in either clinical practice or surgical trials. This report establishes supplementary criteria for this classification to standardize the evaluation of postoperative complications in clinical trials.


METHODS
The Japan Clinical Oncology Group (JCOG) commissioned a committee. Members from nine surgical study groups (gastric, esophageal, colorectal, lung, breast, gynecologic, urologic, bone and soft tissue, and brain) specified postoperative complications experienced commonly in their fields and defined more detailed grading criteria for each complication in accordance with the general grading rules of the Clavien-Dindo classification.


RESULTS
We listed 72 surgical complications experienced commonly in surgical trials, focusing on 17 gastroenterologic complications, 13 infectious complications, six thoracic complications, and several other complications. The grading criteria were defined simply and were optimized for surgical complications.


CONCLUSIONS
The JCOG postoperative complications criteria (JCOG PC criteria) aim to standardize the terms used to define adverse events (AEs) and provide detailed grading guidelines based on the Clavien-Dindo classification. We believe that the JCOG PC criteria will allow for more precise comparisons of the frequency of postoperative complications among trials across many different surgical fields.
Japan Clinical Oncology Group Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan.
Hiroshi
H
Katayama
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Yukinori
Y
Kurokawa
Japan Clinical Oncology Group Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan.
Kenichi
K
Nakamura
Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Hiroyuki
H
Ito
Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
Yukihide
Y
Kanemitsu
Department of Surgery, Breast Oncology, National Hospital Organization, Osaka National Hospital, Osaka, Japan.
Norikazu
N
Masuda
Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Yasuhiro
Y
Tsubosa
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Toyomi
T
Satoh
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Akira
A
Yokomizo
Japan Clinical Oncology Group Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan.
Haruhiko
H
Fukuda
Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan. msasako@hyo-med.ac.jp.
Mitsuru
M
Sasako
D002965:Classification / Q000379:methods*; D032802:Committee Membership; D006801:Humans; D007564:Japan; D008495:Medical Oncology / Q000458:organization & administration*; D011183:Postoperative Complications / Q000145:classification*; D012015:Reference Standards
Clavien-Dindo classification; JCOG postoperative complications criteria (JCOG PC criteria); Postoperative complications