Postoperative Infectious Complications Impact Long-Term Survival in Patients Who Underwent Hepatectomies for Colorectal Liver Metastases: a Propensity Score Matching Analysis

Abstract : OBJECTIVE: Postoperative complications strongly impact the postoperative course and long-term outcome of patients who underwent liver resection for colorectal liver metastases (CRLM). Among them, infectious complications play a relevant role. The aim of this study was to evaluate if infectious complications still impact overall and disease-free survival after liver resection for CRLM once patients were matched with a propensity score matching analysis based on Fong's criteria. METHODS: A total of 2281 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched with a 1:3 propensity score analysis in order to compare patients with (INF+) and without (INF-) postoperative infectious complications. RESULTS: Major resection (OR = 1.69 (1.01-2.89), p = 0.05) and operative time (OR = 1.1 (1.1-1.3), p = 0.05) were identified as risk factors of infectious complications. After propensity score matching, infectious complications are associated with overall survival (OS), with 1-, 3-, 5-year OS at 94, 81, and 66% in INF- and 92, 66, and 57% in INF+ respectively (p = 0.01). Disease-free survival (DFS) was also different with regard to 1-, 3-, 5-year survival at 65, 41, and 22% in R0 vs. 50, 28, and 17% in INF+ (p = 0.007). CONCLUSION: Infectious complications are associated with decreased overall and disease-free survival rates.
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Journal articles
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https://hal.archives-ouvertes.fr/hal-02318701
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Submitted on : Thursday, October 17, 2019 - 12:49:18 PM
Last modification on : Tuesday, October 22, 2019 - 2:25:10 PM

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Riccardo Memeo, Vito Blasi, Rene Adam, Diane Goéré, Alexis Laurent, et al.. Postoperative Infectious Complications Impact Long-Term Survival in Patients Who Underwent Hepatectomies for Colorectal Liver Metastases: a Propensity Score Matching Analysis. Journal of Gastrointestinal Surgery, Springer Verlag, 2018, 22 (12), pp.2045--2054. ⟨10.1007/s11605-018-3854-2⟩. ⟨hal-02318701⟩

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