98P - Real clinical impact of postoperative surgical complications after colon cancer surgery

Background

We investigate whether the continuation of adjuvant treatment and clinical course of adjuvant treatment would be affected by the development of postoperative complications in the patients who underwent curative resection for colon cancer in a pooled analysis of two large phase III studies performed in Japan.

Methods

The study examined the patients who enrolled in 1303, phase III comparing the efficacy of 6 months and 12 months of capecitabine as adjuvant chemotherapy for stage III colon cancer patients and in 882, a phase III to confirm tolerability oxaliplatin, fluorouracil, and l-leucovorin in Japanese stage II/III colon cancer patients. In this study, POCs were defined as the following major surgical complication; Anastomotic leakage, Pneumonia, Bowel obstruction/ileus, Surgical site infection, Postoperative bleeding, Urinary tract infection, and Fistula. The patients were classified as those with POCs (C group) and those without POCs (NC group).

Results

2095 patients were examined in the present study. POCs were observed in 169 patients (8.1%). The overall survival rates at five-year after surgery was 75.3% in the C-group and 86.5% in NC-group, respectively (p=0.0017). Hazard ratio of POCs for OS was 1.77 (95% confidence interval, 1.23 to 2.54; p=0.0017). Time to adjuvant treatment failure (TTF) of adjuvant chemotherapy was almost similar; 6-months TTF was 68.6% in C-group and 67.1% in NC-group. Dose reduction rate of adjuvant chemotherapy and adjuvant treatment suspension rate were also similar between C-group and NC-group (45.0% vs 48.7%, p=0.3520 and 52.7% vs 55.0%, p=0.5522, respectively).

Conclusions

POCs were associated with the poor prognosis, while the POCs did not affect the intensity of adjuvant chemotherapy. These results suggested that the POCs itself have negative survival impact.

Clinical trial identification

Editorial acknowledgement

This study was supported, in part, by the non-profit organization Epidemiological & Clinical Research Information Network (ECRIN).

Legal entity responsible for the study

Japanese Foundation for Multidisciplinary Treatment of Cancer.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.