The impact of the type and severity of postoperative complications on long-term outcomes following surgery for colorectal cancer: A systematic review and meta-analysis

• Systematic review and meta-analysis of long term outcomes after surgery for colorectal cancer.
• Reports significant association between complication type and severity, and cancer outcomes and survival.
• Both complication type and severity have a negative impact on long term outcomes.
• No published work directly compared the two definitions of postoperative complications.

BackgroundThis systematic review investigated the impact of complications by type (infective vs. non-infective) and severity (using the Clavien Dindo scale) on long-term outcome following surgery for colorectal cancer.MethodsA systematic review was performed using appropriate keywords. Meta-analysis using a random effects model was performed.Results14 studies were included with a total 18,611 patients. Infective complications had a significant impact on disease free (HR 1.41, 95%CI 1.08–1.83, p = 0.01) and overall survival (1.37 95%CI 1.22–1.55, p < 0.001). Non-infective complications had no significant impact on either disease free (HR 1.21, 95%CI 0.97–1.52, p = 0.09) or overall survival (HR 1.35, 95%CI 0.92–1.97, p = 0.12). Complication severity had a significant impact on both disease free (HR 1.41, 95%CI 1.18–1.68, p < 0.001) and overall survival (HR 1.45, 95%CI 1.25–1.69, p < 0.001).DiscussionBoth type and severity of postoperative complications have an impact on long-term survival following surgery for colorectal cancer.