Risk factors and prognostic significance of postoperative complications following lateral pelvic lymph node dissection for rectal cancer: results of the multicenter lateral node study in China
单位：[1]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[2]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Hebei Cancer Hospital, Chinese Academy of Medical Sciences, Langfang, China河北医科大学第四医院[3]Department of Colorectal Surgery, Changhai Hospital, Nava Military Medical University, Shanghai, China[4]Department of Gastrointestinal Surgery, Affiliated Hospital, Xuzhou Medical College, Xuzhou, China[5]Department of Gastrointestinal Surgery, RuiJin Hospital, Shanghai Jiao Tong University School of Medicine[6]Shanghai Minimally Invasive Surgery Center, Shanghai, China ,Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing, China临床科室国家中心普外分中心普外五科（综合普外科）首都医科大学附属北京友谊医院[7]Department of Anorectal, Tianjin People’s Hospital, Tianjin, China
This study shows that patients with risk factors should undergo adequate preoperative evaluation and preparation to shorten the operative time as well as close postoperative monitoring after LPND. Objective Total mesorectal excision (TME) plus lateral pelvic lymph node (LPN) dissection (LPND) is a technically complex and challenging procedure with higher morbidity than TME alone. We aimed to investigate the risk factors for postoperative complications after TME + LPND, and the impact of complications on patient prognosis. Methods A total of 387 rectal cancer patients with clinical LPN metastasis (LPNM) who underwent TME + LPND at three institutions affiliated with the Chinese Lateral Node Collaborative Group were included. Logistic regression models were used to identify the risk factors for post-surgical complications, and the log-rank test was used to compare the prognosis. Severe complications were described as grade III-V. Results The incidence rates of overall complications and severe complications after TME + LPND were 15.2% (59/387) and 7.8% (30/387), respectively. Multivariate analysis showed that a duration of operation >= 260 min was an independent risk factor for both overall (odds ratio [OR] = 3.03, 95% confidence interval [CI] = 1.57-5.85, P = 0.001) and severe postoperative complications (OR = 2.67, 95% CI = 1.06-6.73, P = 0.037). The development of overall postoperative complications (P = 0.114) and severe postoperative complications (P = 0.298) had no significant impact on the overall survival. However, patients with overall complications (P = 0.015) or severe complications (P = 0.031) with a postoperative hospital stay >30 days had significantly an overall worse survival. Conclusion A surgical duration of >= 260 min is a significant risk factor for both overall and severe postoperative complications after TME + LPND for middle-low rectal cancer. Furthermore, the development of overall complications or severe complications that require a postoperative hospital stay >30 days significantly worsens the prognosis.
基金：
National Key Research and Development Program/Prevent and Control Research for Important Non-Communicable Diseases [2019YFC1315705]; Medicine and Health Technology Innovation Project of the Chinese Acadmy of Medical Sciences [2017-12M-1e006]
第一作者单位：[1]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[7]Department of Anorectal, Tianjin People’s Hospital, Tianjin, China[*1]190 Mustard Garden Road, Hongqiao District, Tianjin, 300121.[*2]17 Panjiayuan Nanli, Chaoyang District, Beijing, 100021
推荐引用方式(GB/T 7714)：
Zhou Sicheng,Tang Jianqiang,Mei Shiwen,et al.Risk factors and prognostic significance of postoperative complications following lateral pelvic lymph node dissection for rectal cancer: results of the multicenter lateral node study in China[J].JAPANESE JOURNAL of CLINICAL ONCOLOGY.2022,doi:10.1093/jjco/hyac109.
APA：
Zhou, Sicheng,Tang, Jianqiang,Mei, Shiwen,Lou, Zheng,Fu, Wei...&Liu, Qian.(2022).Risk factors and prognostic significance of postoperative complications following lateral pelvic lymph node dissection for rectal cancer: results of the multicenter lateral node study in China.JAPANESE JOURNAL of CLINICAL ONCOLOGY,,
MLA：
Zhou, Sicheng,et al."Risk factors and prognostic significance of postoperative complications following lateral pelvic lymph node dissection for rectal cancer: results of the multicenter lateral node study in China".JAPANESE JOURNAL of CLINICAL ONCOLOGY .(2022)
