Abstract
PurposeThe purpose of this meta-analysis was to evaluate the effect of liver cirrhosis (LC) on the short-term and long-term surgical outcomes of colorectal cancer (CRC).MethodsThe PubMed, Embase, and Cochrane Library databases were searched from inception to March 23, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of enrolled studies, and RevMan 5.3 was used for data analysis in this meta-analysis. The registration ID of this current meta-analysis on PROSPERO is CRD42021238042.ResultsIn total, five studies with 2485 patients were included in this meta-analysis. For the baseline information, no significant differences in age, sex, tumor location, or tumor T staging were noted. Regarding short-term outcomes, the cirrhotic group had more major complications (OR=5.15, 95% CI=1.62 to 16.37, p=0.005), a higher re-operation rate (OR=2.04, 95% CI=1.07 to 3.88, p=0.03), and a higher short-term mortality rate (OR=2.85, 95% CI=1.93 to 4.20, p<0.00001) than the non-cirrhotic group. However, no significant differences in minor complications (OR=1.54, 95% CI=0.78 to 3.02, p=0.21) or the rate of intensive care unit (ICU) admission (OR=0.76, 95% CI=0.10 to 5.99, p=0.80) were noted between the two groups. Moreover, the non-cirrhotic group exhibited a longer survival time than the cirrhotic group (HR=2.96, 95% CI=2.28 to 3.85, p<0.00001).ConclusionPreexisting LC was associated with an increased postoperative major complication rate, a higher rate of re-operation, a higher short-term mortality rate, and poor overall survival following CRC surgery.
Highlights
Liver cirrhosis (LC) is a common disease, causing 1.03 million deaths per year worldwide [1]
Comorbidity, clinical stage, anastomosis methods, and total mesorectal excision are reported to have an effect on the outcome of colorectal cancer (CRC) surgery [9,10,11,12]
Patient characteristics and quality assessment of the included studies In total, five studies with 2485 patients were included in this meta-analysis
Summary
Liver cirrhosis (LC) is a common disease, causing 1.03 million deaths per year worldwide [1]. Infection with hepatitis viruses, and nonalcoholic liver disease are the leading causes of LC [2]. The pathological process of LC results from different mechanisms of liver injury, which leads to necroinflammation and fibrogenesis of liver tissues [3]. Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths worldwide [7]. Radical resection of the colorectal tumors has been widely accepted as a curative treatment [8]. Comorbidity, clinical stage, anastomosis methods, and total mesorectal excision are reported to have an effect on the outcome of CRC surgery [9,10,11,12]
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