Background. The importance of post-operative complications in determining cancer-specific survival is controversial and ill-defined. Aim. This study analyzes the influence of surgical morbidity on long-term survival after resection of hepatic CRM. Methods. Demographic, disease-specific and operative data were recorded for consecutive patients submitted to resection of hepatic CRM. A clinical risk score (CRS) was used to stratify patients according to disease extent. Complications were graded

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... severity; cancer-specific survival was compared for patients with (COMP) and without (NO COMP) non-fatal complications. Results. Of the 1106 patients submitted to resection (1991 Á03), 26 (2.4%) died perioperatively; 454 of the remaining 1080 (42%) had at least 1 complication, 194 of which were severe (17.9%, grade 3 or 4). COMP patients had more co-morbidities, more extensive operations and more advanced disease (higher CRS) compared to NO COMP (Table ) ; however, at a median follow-up of 26.5 months, disease-specific survival was no different between the two groups (p 0/0.1). Operative morbidity in the entire cohort (42%) was similar to that of patients who survived at least 3 (38.9%) or 5 (40.7%) years. Further sub-group and multivariate analyses identified no adverse impact of operative morbidity on survival. Conclusion. Post-operative complications after hepatic resection of hepatic CRM do not adversely affect cancer-specific survival.