Influence of socioeconomic position on surgical outcomes after resection of colorectal liver metastases

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BACKGROUND: This study investigate the impact of socioeconomic position (SEP) on postoperative outcomes after resection of colorectal liver metastases (CRLM). METHODS: This retrospective population-based study used data from the Dutch Hepatobiliary Audit, including all patients who underwent liver resection for CRLM, between 2014 and 2018. Neighbourhood SEP (nSEP) characteristics were obtained from Statistics Netherlands, using welfare, education, and labour participation data. The lowest 20 % defines the Low group, the top 20 % the high group. The association of nSEP with short-term postoperative outcomes and overall survival (OS) was assessed. RESULTS: Of 3549 patients who underwent resection, 2579 (72.6 %) were successfully linked between databases. Median (IQR) nSEP scores did not significantly differ from those in the general population. Patients with higher nSEP scores had lower ASA scores (P < 0.001). No differences in 30-day mortality (1.4 % vs 1.2 % vs 1.0 %, p = 0.625) or major morbidity (10 % vs 9.7 % vs 11 %, p = 0.809) were observed between low, medium, or high nSEP. 5-year OS rates were similar: low, 45.7 % (41.4-50.4), medium, 45.9 % (43.3-48.6), high, 50.9 % (46.6-55.7), P-log rank = 0.441. CONCLUSION: In patients selected for resection of CRLM, nSEP was not associated with postoperative outcomes or survival. Patients should not be withheld from liver resection for CRLM based on SEP.

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