Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for...

Area of Science:

• Oncology
• Surgical Outcomes
• Public Health

Background:

• Long-term survival impact of early morbidity after colorectal cancer (CRC) surgery is debated.
• Understanding postoperative complication effects is crucial for improving CRC patient outcomes.

Purpose of the Study:

• To investigate the association between postoperative complications and long-term survival in colorectal cancer (CRC) patients.
• To differentiate the impact of infectious versus noninfectious complications on survival.

Main Methods:

• Linked Veterans Affairs databases (Surgical Quality Improvement Program, Central Cancer Registry) for 12,075 CRC patients (1999-2009).
• Categorized complications as any, noninfectious, or infectious within 30 days.
• Performed survival analyses adjusted for patient, disease, and treatment factors, excluding early deaths.

Main Results:

• Overall morbidity was 27.8%, with infectious complications at 22.5%.
• Any complication independently reduced long-term survival (HR 1.24).
• Infectious complications (HR 1.31) and severe infections (HR 1.41) significantly decreased survival.

Conclusions:

• Postoperative complications after CRC resection are linked to reduced long-term survival.
• Infectious complications, particularly severe ones, are the primary contributors to this survival deficit.
• Findings are independent of patient, disease, and treatment characteristics.