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Postoperative complications and emergency surgeries in colorectal cancer patients <50 years—a national cohort study

Gutlic, Ida LU orcid ; Saraste, Deborah ; Nordenvall, Caroline ; Martling, Anna ; Lydrup, Marie Louise LU and Buchwald, Pamela LU (2024) In Colorectal Disease 26(7). p.1397-1404
Abstract

Aim: The incidence of colorectal cancer (CRC) in Sweden is increasing in individuals <50 years. This study aimed to examine differences in postoperative 30-day complications and rate of emergency surgeries in CRC patients <50 years at diagnosis compared to older age groups since population-based research on this topic is scarce. Method: This population-based study included data from the Swedish Colorectal Cancer Registry for patients undergoing CRC resection between 2010 and 2018. Bivariate analysis and logistic regression were used to analyse the relationship between age groups (<50, 50–79 and ≥80 years) and probability of postoperative 30-day complications adjusted for gender, tumour localization, neoadjuvant... (More)

Aim: The incidence of colorectal cancer (CRC) in Sweden is increasing in individuals <50 years. This study aimed to examine differences in postoperative 30-day complications and rate of emergency surgeries in CRC patients <50 years at diagnosis compared to older age groups since population-based research on this topic is scarce. Method: This population-based study included data from the Swedish Colorectal Cancer Registry for patients undergoing CRC resection between 2010 and 2018. Bivariate analysis and logistic regression were used to analyse the relationship between age groups (<50, 50–79 and ≥80 years) and probability of postoperative 30-day complications adjusted for gender, tumour localization, neoadjuvant (chemo)radiotherapy and American Society of Anesthesiologists score. Results: In total 33 320 patients were included. Patients <50 years had a lower American Society of Anesthesiologists score, more advanced tumours and received more neoadjuvant treatment. Emergency surgeries were less common in the youngest age group (P < 0.001) as well as overall postoperative 30-day complications: ORadj 0.84 (95% CI 0.74–0.96) compared to those ≥80 years. Surgical complications were more common in age groups <50 and 50–79 years (16.5% and 16.9% respectively) compared to patients ≥80 years (14.1%) (P < 0.001). Anastomotic leakage and intra-abdominal infections were more frequent in patients <50 years (5.7% and 3.5% respectively) compared to age groups 50–79 years (5.1% and 2.8% respectively) and ≥80 years (3.5% and 2.1% respectively) (P < 0.001). Wound infections were more common in the two youngest age groups compared to patients ≥80 years (5.3% vs. 3.7% respectively) (P < 0.001). Conclusion: Colorectal cancer patients <50 years and 50–79 years had a higher proportion of surgical complications regarding anastomotic leakage, intra-abdominal infections and wound infections but lower overall postoperative complications. The incidence of surgical emergencies was highest amongst patients ≥80 years. Postoperative diagnostic workup in symptomatic individuals <50 years is warranted.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
colorectal cancer, postoperative complications, Sweden
in
Colorectal Disease
volume
26
issue
7
pages
8 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85195551720
  • pmid:38858822
ISSN
1462-8910
DOI
10.1111/codi.17058
language
English
LU publication?
yes
id
374f27bc-ba2f-4596-95c1-e149f73964cc
date added to LUP
2024-10-07 14:32:51
date last changed
2025-07-15 14:52:10
@article{374f27bc-ba2f-4596-95c1-e149f73964cc,
  abstract     = {{<p>Aim: The incidence of colorectal cancer (CRC) in Sweden is increasing in individuals &lt;50 years. This study aimed to examine differences in postoperative 30-day complications and rate of emergency surgeries in CRC patients &lt;50 years at diagnosis compared to older age groups since population-based research on this topic is scarce. Method: This population-based study included data from the Swedish Colorectal Cancer Registry for patients undergoing CRC resection between 2010 and 2018. Bivariate analysis and logistic regression were used to analyse the relationship between age groups (&lt;50, 50–79 and ≥80 years) and probability of postoperative 30-day complications adjusted for gender, tumour localization, neoadjuvant (chemo)radiotherapy and American Society of Anesthesiologists score. Results: In total 33 320 patients were included. Patients &lt;50 years had a lower American Society of Anesthesiologists score, more advanced tumours and received more neoadjuvant treatment. Emergency surgeries were less common in the youngest age group (P &lt; 0.001) as well as overall postoperative 30-day complications: OR<sub>adj</sub> 0.84 (95% CI 0.74–0.96) compared to those ≥80 years. Surgical complications were more common in age groups &lt;50 and 50–79 years (16.5% and 16.9% respectively) compared to patients ≥80 years (14.1%) (P &lt; 0.001). Anastomotic leakage and intra-abdominal infections were more frequent in patients &lt;50 years (5.7% and 3.5% respectively) compared to age groups 50–79 years (5.1% and 2.8% respectively) and ≥80 years (3.5% and 2.1% respectively) (P &lt; 0.001). Wound infections were more common in the two youngest age groups compared to patients ≥80 years (5.3% vs. 3.7% respectively) (P &lt; 0.001). Conclusion: Colorectal cancer patients &lt;50 years and 50–79 years had a higher proportion of surgical complications regarding anastomotic leakage, intra-abdominal infections and wound infections but lower overall postoperative complications. The incidence of surgical emergencies was highest amongst patients ≥80 years. Postoperative diagnostic workup in symptomatic individuals &lt;50 years is warranted.</p>}},
  author       = {{Gutlic, Ida and Saraste, Deborah and Nordenvall, Caroline and Martling, Anna and Lydrup, Marie Louise and Buchwald, Pamela}},
  issn         = {{1462-8910}},
  keywords     = {{colorectal cancer; postoperative complications; Sweden}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{1397--1404}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Colorectal Disease}},
  title        = {{Postoperative complications and emergency surgeries in colorectal cancer patients <50 years—a national cohort study}},
  url          = {{http://dx.doi.org/10.1111/codi.17058}},
  doi          = {{10.1111/codi.17058}},
  volume       = {{26}},
  year         = {{2024}},
}