Impact of Chronic Obstructive Pulmonary Disease on surgical outcomes of Patients with Colorectal cancer

Background: The impact of chronic obstructive pulmonary disease (COPD) on perioperative complications and prognosis in patients with colorectal cancer (CRC) is explored. Methods: Fifty-eight CRC patients with COPD and 671 CRC patients without COPD who underwent surgery for CRC in our hospital were retrospectively analyzed. Sociodemographic and clinical variables including tumor status, operative and anesthesia duration, length of hospital stay, the time of postoperative catheter removal and first defecation were compared between the two cohorts. Furthermore, postoperative intensive care unit (ICU) admission, use of mechanical ventilation, fiberoptic bronchoscopy rates, postoperative antibiotic treatment, presence of complications and cancer-specific survival (CSS) or disease-free survival (DFS) were analyzed. Finally, COX regression analysis was used to identify independent risk factors for overall survival (OS) in CRC patients. Results: COPD and Tumor-Node-Metastasis (TNM) stages were independent risk factors for the postoperative OS in patients undergoing surgery for CRC. Moreover, time of postoperative urinary catheter removal and first defecation, ICU admission, use of mechanical ventilation, and fiberoptic bronchoscopy rates were significantly higher in CRC patients with COPD than in those without COPD. Furthermore, postoperative pneumonia and septic shock were more common in patients with COPD. However, COPD was not associated with CSS or DFS in CRC patients. Conclusions: COPD is an independent risk factor for OS in CRC patients after surgery, and is correlated with more postoperative complications, but it is not associated with CSS or DFS. Thus, surgical resection is recommended for selective CRC patients with COPD under the condition of more intensive postoperative care.