Postoperative complications are associated with worse survival after laparoscopic surgery for non-metastatic colorectal cancer – interim analysis of 3-year overall survival

Introduction: Postoperative morbidity after colorectal resections for cancer remains a significant problem. Data on the influence of complications on survival after laparoscopic colorectal resection are still limited. Aim: To analyze the impact of postoperative complications on long-term survival after radical laparoscopic resection for colorectal cancer. Material and methods: Two hundred and sixty-five consecutive non-metastatic colorectal cancer patients undergoing laparoscopic colorectal resection for cancer were included in the analysis. The entire study group was divided into two subgroups based on the occurrence of postoperative complications. Group 1 included patients without postoperative morbidity and group 2 included patients with complications. The primary outcome was overall survival. Results: Median follow-up was 45 (IQR: 34-55) months. Group 1 consisted of 187 (70.5%) patients and group 2 comprised 78 (29.5%) patients. Studied groups were comparable in terms of sex, age, body mass index, ASA class, cancer staging, localization of the tumor and operative time. Patients in group 1 had significantly better overall 3-year survival compared to those with complications (84.9% vs. 69.8%, p = 0.022). Kaplan-Meier curves showed significantly improved survival rates in patients without complications compared with complicated cases. The Cox proportional multivariate model showed that postoperative complications (HR = 2.83; 95% CI: 1.35-5.92; p = 0.0058) and AJCC III (HR = 3.17; 95% CI: 1.52-6.6; p = 0.0021) were independent predictors of worse survival after laparoscopic colorectal cancer surgery. Conclusions: Our analysis of interim results after 3 years confirms that complications after laparoscopic colorectal cancer surgery have an impact on survival. For this reason, these patients should be carefully monitored after surgery aiming at early detection of recurrence.