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Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality

PURPOSE: To analyze short-term outcomes of curative-intent cancer surgery in all adult patients diagnosed with colorectal cancer undergoing surgery from January 2010 to December 2019 and determine risk factors for postoperative complications and mortality. METHODS: Retrospective study conducted at a...

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Autores principales: Moro-Valdezate, David, Martín-Arévalo, José, Ferro-Echevarría, Óscar, Pla-Martí, Vicente, García-Botello, Stephanie, Pérez-Santiago, Leticia, Gadea-Mateo, Ricardo, Tarazona, Noelia, Roda, Desamparados, Roselló-Keränen, Susana, Espí-Macías, Alejandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722849/
https://www.ncbi.nlm.nih.gov/pubmed/36129528
http://dx.doi.org/10.1007/s00423-022-02688-1
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author Moro-Valdezate, David
Martín-Arévalo, José
Ferro-Echevarría, Óscar
Pla-Martí, Vicente
García-Botello, Stephanie
Pérez-Santiago, Leticia
Gadea-Mateo, Ricardo
Tarazona, Noelia
Roda, Desamparados
Roselló-Keränen, Susana
Espí-Macías, Alejandro
author_facet Moro-Valdezate, David
Martín-Arévalo, José
Ferro-Echevarría, Óscar
Pla-Martí, Vicente
García-Botello, Stephanie
Pérez-Santiago, Leticia
Gadea-Mateo, Ricardo
Tarazona, Noelia
Roda, Desamparados
Roselló-Keränen, Susana
Espí-Macías, Alejandro
author_sort Moro-Valdezate, David
collection PubMed
description PURPOSE: To analyze short-term outcomes of curative-intent cancer surgery in all adult patients diagnosed with colorectal cancer undergoing surgery from January 2010 to December 2019 and determine risk factors for postoperative complications and mortality. METHODS: Retrospective study conducted at a single tertiary university institution. Patients were stratified by age into two groups: < 75 years and ≥ 75 years. Primary outcome was the influence of age on 30-day complications and mortality. Independent risk factors for postoperative adverse events or mortality were analyzed, and two novel nomograms were constructed. RESULTS: Of the 1486 patients included, 580 were older (≥ 75 years). Older subjects presented more comorbidities and tumors were located mainly in right colon (45.7%). After matching, no between-group differences in surgical postoperative complications were observed. The 30-day mortality rate was 5.3% for the older and 0.8% for the non-older group (p < 0.001). In multivariable analysis, the independent risk factors for postoperative complications were peripheral vascular disease, chronic pulmonary disease, severe liver disease, postoperative transfusion, and surgical approach. Independent risk factors for 30-day mortality were age ≥ 80 years, cerebrovascular disease, severe liver disease, and postoperative transfusion. The model was internally and externally validated, showing high accuracy. CONCLUSION: Patients aged ≥ 75 years had similar postoperative complications but higher 30-day mortality than their younger counterparts. Patients with peripheral vascular disease, chronic pulmonary disease, or severe liver disease should be informed of higher postoperative complications. But patients aged ≥ 80 suffering cerebrovascular disease, severe liver disease, or needing postoperative transfusion should be warned of significantly increased risk of postoperative mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-022-02688-1.
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spelling pubmed-97228492022-12-07 Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality Moro-Valdezate, David Martín-Arévalo, José Ferro-Echevarría, Óscar Pla-Martí, Vicente García-Botello, Stephanie Pérez-Santiago, Leticia Gadea-Mateo, Ricardo Tarazona, Noelia Roda, Desamparados Roselló-Keränen, Susana Espí-Macías, Alejandro Langenbecks Arch Surg Research PURPOSE: To analyze short-term outcomes of curative-intent cancer surgery in all adult patients diagnosed with colorectal cancer undergoing surgery from January 2010 to December 2019 and determine risk factors for postoperative complications and mortality. METHODS: Retrospective study conducted at a single tertiary university institution. Patients were stratified by age into two groups: < 75 years and ≥ 75 years. Primary outcome was the influence of age on 30-day complications and mortality. Independent risk factors for postoperative adverse events or mortality were analyzed, and two novel nomograms were constructed. RESULTS: Of the 1486 patients included, 580 were older (≥ 75 years). Older subjects presented more comorbidities and tumors were located mainly in right colon (45.7%). After matching, no between-group differences in surgical postoperative complications were observed. The 30-day mortality rate was 5.3% for the older and 0.8% for the non-older group (p < 0.001). In multivariable analysis, the independent risk factors for postoperative complications were peripheral vascular disease, chronic pulmonary disease, severe liver disease, postoperative transfusion, and surgical approach. Independent risk factors for 30-day mortality were age ≥ 80 years, cerebrovascular disease, severe liver disease, and postoperative transfusion. The model was internally and externally validated, showing high accuracy. CONCLUSION: Patients aged ≥ 75 years had similar postoperative complications but higher 30-day mortality than their younger counterparts. Patients with peripheral vascular disease, chronic pulmonary disease, or severe liver disease should be informed of higher postoperative complications. But patients aged ≥ 80 suffering cerebrovascular disease, severe liver disease, or needing postoperative transfusion should be warned of significantly increased risk of postoperative mortality. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00423-022-02688-1. Springer Berlin Heidelberg 2022-09-21 2022 /pmc/articles/PMC9722849/ /pubmed/36129528 http://dx.doi.org/10.1007/s00423-022-02688-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Moro-Valdezate, David
Martín-Arévalo, José
Ferro-Echevarría, Óscar
Pla-Martí, Vicente
García-Botello, Stephanie
Pérez-Santiago, Leticia
Gadea-Mateo, Ricardo
Tarazona, Noelia
Roda, Desamparados
Roselló-Keränen, Susana
Espí-Macías, Alejandro
Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title_full Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title_fullStr Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title_full_unstemmed Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title_short Short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
title_sort short-term outcomes of colorectal cancer surgery in older patients: a novel nomogram predicting postoperative morbi-mortality
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9722849/
https://www.ncbi.nlm.nih.gov/pubmed/36129528
http://dx.doi.org/10.1007/s00423-022-02688-1
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