Post-operative complications do not independentlypredict long-term survival following resection of colorectal liver metastases if analyses incorporate systemic inflammatory variables: LTP70

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Aim:Postoperative complications have repeatedly been shown topredict poor long-termprognosis following resection of colorectal liver metastases, via an undetermined mechanism. Recently it was demonstrated that thepreoperative systemic inflammatory response, a knownpredictor of poor survival following metastasectomy, itself independentlypredicted the development of postoperative infectious complications followingprimary colorectal cancer resection. The aim of this study was to determine whether postoperative complications maintainprognostic significance in survival analyses that incorporate systemic inflammatory variables.Method:Multivariable analyses were performed to correlatepreoperative and perioperative variables with long-term survival of two hundred two patients undergoing metastasectomy between January 2000 and April 2006Results:Ninety-day mortality and morbidity rates were 2.0% and 25.7% respectively. Thepreoperative systemic inflammatory response independentlypredicted the development of infectious complications following hepatectomy, along with performance of trisectionectomy. Infectious complications were associated with shortened overall and disease-free survival following metastasectomy, but lost independent significance when systemic inflammatory variables were included in multivariable analyses.Conclusions:Whilst infectious complications are associated with poor long-termprognosis following metastasectomy, they lacked independentprognostic value when systemic inflammatory parameters were also considered, suggesting that much of theirprognostic value arises from their association with thepreoperative systemic inflammatory response.

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