局所進行大腸癌の併存疾患患者における身体的状態と術後合併症の相関

Colon cancer is one of the five most common cancers worldwide, leading to more than 500.000 deaths annually. It is known that the prevalence of colon cancer increases in parallel with increasing age, which is often associated with an increase in the number of concomitant diseases. The latter, both individually and in combination with each other, can have an impact on the safety of performing surgical interventions.

To evaluate the relationship between somatic status and the incidence of postoperative complications in comorbid patients with locally advanced colon cancer.

The study was prospective in nature. The study included 254 patients who underwent surgery for locally advanced colon cancer (cT4N0M0, cT1-4 N1-2 M0). 66.1% of patients had stage II of the disease, 33.9% of patients had stage III. Information on somatic status was analyzed for all patients with the calculation of the Charlson comorbidity index, as well as on the presence of complications in the early and late postoperative period. Statistical data analysis was performed using the RStudio software (version 2024.12.1+563) in the R programming language.

Various complications of surgical interventions in patients with locally advanced colon cancer were noted in 9.8% of cases. A total of 42 complications were identified in 25 patients. The most common complication was the formation of a postoperative hernia, which occurred in 11 patients (44.0% of all complications and 4.3% of the total sample). The second most common complication was seromas, which formed in 9 patients (36.0% of all complications and 3.5% of the total sample). In the course of a multifactorial logistic regression analysis, it was shown that the independent risk factors for postoperative complications in comorbid patients with locally advanced colon cancer are the duration of surgery and the Charlson comorbidity index. Thus, an operation duration of more than 240 minutes increases the chance of postoperative complications by 3.1 times (OR=3.100; 95% CI=1.250-7.681; p=0.015), and the Charlson comorbidity index of 9 or more increases the chance of postoperative complications by 4.927 times (OR=4.927; 95% CI=1.340-18.122; p=0.016).

The somatic status of patients has a significant impact on the postoperative complications of radical surgical interventions in patients with locally advanced colon cancer. At the same time, it is most appropriate not to evaluate individual concomitant diseases, but a comprehensive assessment of somatic status using the Charlson comorbidity index, which, along with the duration of surgery, acts as an independent predictor of postoperative complications.