Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404)
Abstract Objective To determine risk factors for early postoperative complications after D3 dissection for stage II/III colon cancer. Background Identification of risk factors for postoperative complications is essential in patients surgically treated for colon cancer. The Japan Clinical Oncology Gr...
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doaj-f76bf3cbad5c451ca5b8e79f0ddccc292021-05-02T19:21:59ZengWileyAnnals of Gastroenterological Surgery2475-03282019-05-013331031710.1002/ags3.12246Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404)Yusuke Nishizawa0Tomonori Akagi1Masafumi Inomata2Hiroshi Katayama3Junki Mizusawa4Seiichiro Yamamoto5Masaaki Ito6Tadahiko Masaki7Masahiko Watanabe8Yasuhiro Shimada9Seigo Kitano10Division of Gastroenterological Surgery Saitama Cancer Center Kitaadachi‐gun Saitama JapanFaculty of Medicine, Gastroenterological and Pediatric Surgery Oita University Yufu Oita JapanFaculty of Medicine, Gastroenterological and Pediatric Surgery Oita University Yufu Oita JapanJCOG Operations Office National Cancer Center Hospital Tokyo JapanJCOG Data Center National Cancer Center Hospital Tokyo JapanDepartment of Surgery Hiratsuka City Hospital Hiratsuka Kanagawa JapanDepartment of Colorectal Surgery National Cancer Center Hospital East Kashiwa Chiba JapanDepartment of Surgery Kyorin University Tokyo JapanDepartment of Surgery Kitasato University School of Medicine Sagamihara Kanagawa JapanDepartment of Medical Oncology Kochi Health Sciences Center Kochi JapanOita University Oita JapanAbstract Objective To determine risk factors for early postoperative complications after D3 dissection for stage II/III colon cancer. Background Identification of risk factors for postoperative complications is essential in patients surgically treated for colon cancer. The Japan Clinical Oncology Group (JCOG) conducted a randomized controlled trial, JCOG0404, to confirm the non‐inferiority of laparoscopic surgery (LAP) to open surgery (OP) with D3 dissection for stage II/III colon cancer. This supplementary analysis was made to assess risk factors for surgery requiring D3 dissection using data from JCOG0404. Methods Proportion of postoperative complications of any grade (CTCAE ver. 3.0) until first discharge and risk factors for the most frequent complications were analyzed by univariable and multivariable analysis. Results Among 1057 randomized patients treated between October 2004 and March 2009, 520 patients with OP and 525 patients with LAP were analyzed. Overall postoperative complications of all grades occurred in 190 patients (18.2%). Multivariable analysis showed that the risk factors for overall early postoperative complications were OP itself (odds ratio [OR] 2.01, 95% confidence interval [CI]: 1.38‐2.91, P = 0.0003) and operation time of >240 minutes (OR 1.94, 95% CI: 1.24‐3.02, P = 0.0036). The most frequent adverse event was wound complication (50/1045, 4.8%). In the univariable analysis, reconstruction, greater blood loss, OP, and higher body mass index were significantly associated with wound complication. Conclusion Open surgery and longer operation time of >240 minutes were significant risk factors for postoperative complications. LAP surgery and shorter operation time could contribute to fewer postoperative complications in patients undergoing colectomy with D3 dissection. (Japan Clinical Oncology Group study JCOG 0404: NCT00147134/UMIN‐CTR: C000000105.)https://doi.org/10.1002/ags3.12246colon cancerD3multivariate analysispostoperative complicationrisk factor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yusuke Nishizawa Tomonori Akagi Masafumi Inomata Hiroshi Katayama Junki Mizusawa Seiichiro Yamamoto Masaaki Ito Tadahiko Masaki Masahiko Watanabe Yasuhiro Shimada Seigo Kitano |
spellingShingle |
Yusuke Nishizawa Tomonori Akagi Masafumi Inomata Hiroshi Katayama Junki Mizusawa Seiichiro Yamamoto Masaaki Ito Tadahiko Masaki Masahiko Watanabe Yasuhiro Shimada Seigo Kitano Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) Annals of Gastroenterological Surgery colon cancer D3 multivariate analysis postoperative complication risk factor |
author_facet |
Yusuke Nishizawa Tomonori Akagi Masafumi Inomata Hiroshi Katayama Junki Mizusawa Seiichiro Yamamoto Masaaki Ito Tadahiko Masaki Masahiko Watanabe Yasuhiro Shimada Seigo Kitano |
author_sort |
Yusuke Nishizawa |
title |
Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) |
title_short |
Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) |
title_full |
Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) |
title_fullStr |
Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) |
title_full_unstemmed |
Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: Supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404) |
title_sort |
risk factors for early postoperative complications after d3 dissection for stage ii or iii colon cancer: supplementary analysis of a multicenter randomized controlled trial in japan (jcog0404) |
publisher |
Wiley |
series |
Annals of Gastroenterological Surgery |
issn |
2475-0328 |
publishDate |
2019-05-01 |
description |
Abstract Objective To determine risk factors for early postoperative complications after D3 dissection for stage II/III colon cancer. Background Identification of risk factors for postoperative complications is essential in patients surgically treated for colon cancer. The Japan Clinical Oncology Group (JCOG) conducted a randomized controlled trial, JCOG0404, to confirm the non‐inferiority of laparoscopic surgery (LAP) to open surgery (OP) with D3 dissection for stage II/III colon cancer. This supplementary analysis was made to assess risk factors for surgery requiring D3 dissection using data from JCOG0404. Methods Proportion of postoperative complications of any grade (CTCAE ver. 3.0) until first discharge and risk factors for the most frequent complications were analyzed by univariable and multivariable analysis. Results Among 1057 randomized patients treated between October 2004 and March 2009, 520 patients with OP and 525 patients with LAP were analyzed. Overall postoperative complications of all grades occurred in 190 patients (18.2%). Multivariable analysis showed that the risk factors for overall early postoperative complications were OP itself (odds ratio [OR] 2.01, 95% confidence interval [CI]: 1.38‐2.91, P = 0.0003) and operation time of >240 minutes (OR 1.94, 95% CI: 1.24‐3.02, P = 0.0036). The most frequent adverse event was wound complication (50/1045, 4.8%). In the univariable analysis, reconstruction, greater blood loss, OP, and higher body mass index were significantly associated with wound complication. Conclusion Open surgery and longer operation time of >240 minutes were significant risk factors for postoperative complications. LAP surgery and shorter operation time could contribute to fewer postoperative complications in patients undergoing colectomy with D3 dissection. (Japan Clinical Oncology Group study JCOG 0404: NCT00147134/UMIN‐CTR: C000000105.) |
topic |
colon cancer D3 multivariate analysis postoperative complication risk factor |
url |
https://doi.org/10.1002/ags3.12246 |
work_keys_str_mv |
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