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Surg Today. 2016 Jun;46(6):668-85. doi: 10.1007/s00595-015-1236-x. Epub 2015 Aug 20.

Extended Clavien-Dindo classification of surgical complications: Japan Clinical Oncology Group postoperative complications criteria.

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Japan Clinical Oncology Group Data Center/Operations Office, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan.
Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan.
Department of Thoracic Surgery, Kanagawa Cancer Center, Yokohama, Japan.
Colorectal Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
Department of Surgery, Breast Oncology, National Hospital Organization, Osaka National Hospital, Osaka, Japan.
Division of Esophageal Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.



Prior to publication of the Clavien-Dindo classification in 2004, there were no grading definitions for surgical complications in either clinical practice or surgical trials. This report establishes supplementary criteria for this classification to standardize the evaluation of postoperative complications in clinical trials.


The Japan Clinical Oncology Group (JCOG) commissioned a committee. Members from nine surgical study groups (gastric, esophageal, colorectal, lung, breast, gynecologic, urologic, bone and soft tissue, and brain) specified postoperative complications experienced commonly in their fields and defined more detailed grading criteria for each complication in accordance with the general grading rules of the Clavien-Dindo classification.


We listed 72 surgical complications experienced commonly in surgical trials, focusing on 17 gastroenterologic complications, 13 infectious complications, six thoracic complications, and several other complications. The grading criteria were defined simply and were optimized for surgical complications.


The JCOG postoperative complications criteria (JCOG PC criteria) aim to standardize the terms used to define adverse events (AEs) and provide detailed grading guidelines based on the Clavien-Dindo classification. We believe that the JCOG PC criteria will allow for more precise comparisons of the frequency of postoperative complications among trials across many different surgical fields.


Clavien-Dindo classification; JCOG postoperative complications criteria (JCOG PC criteria); Postoperative complications

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