Authors: Georgios Antonios Margonis Neda Amini Yuhree Kim Thuy B Tran Lauren M Postlewait Shishir K Maithel Tracy S Wang Douglas B Evans Ioannis Hatzaras Rivfka Shenoy John E Phay Kara Keplinger Ryan C Fields Lindsey E Moses Sharon M Weber Ahmed Salem Jason K Sicklick Shady Gad Adam C Yopp John C Mansour QuanYang Duh Natalie Seiser Carmen C Solorzano Colleen M Kiernan Konstantinos I Votanopoulos Edward A Levine George A Poultsides Timothy M Pawlik
Publish Date: 2015/11/06
Volume: 40, Issue: 3, Pages: 706-714
Abstract
The association of postoperative complications with longterm oncologic outcomes remains unclear We sought to determine the incidence of complications among patients who underwent surgery for adrenocortical carcinoma ACC and define the relationship of morbidity with longterm survivalPatients who underwent surgery for ACC between 1993 and 2014 were identified from 13 academic institutions participating in the US ACC group study The incidence and type of the postoperative complications the factors associated with them as well their association with longterm survival were analyzedA total of 265 patients with median age of 52 years IQR 44–63 were identified at surgery the majority of patients underwent an open abdominal procedure n = 169 668 A postoperative complication occurred in 99 patients for a morbidity of 374 five patients 19 died in hospital Factors associated with morbidity included a thoracoabdominal operative approach reference open abdominal OR 285 95 CI 100–818 and a hormonally functional tumor OR 356 95 CI 165–769 all P 005 Presence of any complication was associated with a worse longterm outcome median survival no complication 589 months vs any complication 251 months P = 0009 In multivariate analysis after adjusting for patient and diseaserelated factors postoperative infectious complications independently predicted shorter overall survival hazard ratio HR 556 95 CI 224–1380 P 0001
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