Article ; Online: Meta-analysis of the impact of postoperative infective complications on oncological outcomes in colorectal cancer surgery.
BJS open
2020 Volume 4, Issue 5, Page(s) 737–747
Abstract: Background: Cancer outcomes are complex, involving prevention, early detection and optimal multidisciplinary care. Postoperative infection and surgical site-infection (SSI) are not only uncomfortable for patients and costly, but may also be associated ... ...
| Abstract | Background: Cancer outcomes are complex, involving prevention, early detection and optimal multidisciplinary care. Postoperative infection and surgical site-infection (SSI) are not only uncomfortable for patients and costly, but may also be associated with poor oncological outcomes. A meta-analysis was undertaken to assess the oncological effects of SSI in patients with colorectal cancer. Methods: An ethically approved PROSPERO-registered meta-analysis was conducted following PRISMA guidelines. PubMed and Scopus databases were searched for studies published between 2007 and 2017 reporting the effects of postoperative infective complications on oncological survival in colorectal cancer. Results were separated into those for SSI and those concerning anastomotic leakage. Articles with a Methodological Index for Non-Randomized Studies score of at least 18 were included. Hazard ratios (HRs) with 95 per cent confidence intervals were computed for risk factors using an observed to expected and variance fixed-effect model. Results: Of 5027 articles were reviewed, 43 met the inclusion criteria, with a total of 154 981 patients. Infective complications had significant negative effects on overall survival (HR 1·37, 95 per cent c.i. 1·28 to 1·46) and cancer-specific survival (HR 2·58, 2·15 to 3·10). Anastomotic leakage occurred in 7·4 per cent and had a significant negative impact on disease-free survival (HR 1·14, 1·09 to 1·20), overall survival (HR 1·34, 1·28 to 1·39), cancer-specific survival (HR 1·43, 1·31 to 1·55), local recurrence (HR 1·18, 1·06 to 1·32) and overall recurrence (HR 1·46, 1·27 to 1·68). Conclusion: This meta-analysis identified a significant negative impact of postoperative infective complications on overall and cancer-specific survival in patients undergoing colorectal surgery. |
|---|---|
| MeSH term(s) | Anastomotic Leak/etiology ; Anastomotic Leak/mortality ; Colorectal Neoplasms/microbiology ; Colorectal Neoplasms/mortality ; Colorectal Neoplasms/surgery ; Colorectal Surgery/adverse effects ; Disease-Free Survival ; Humans ; Postoperative Complications ; Surgical Wound Infection/etiology |
| Language | English |
| Publishing date | 2020-06-11 |
| Publishing country | England |
| Document type | Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review |
| ISSN | 2474-9842 |
| ISSN (online) | 2474-9842 |
| DOI | 10.1002/bjs5.50302 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.
Inter-library loan at ZB MED
Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.