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- Title
Does anastomotic leakage after rectal cancer resection worsen long-term oncologic outcome?
- Authors
Hasegawa, Hiroshi; Matsuda, Takeru; Arimoto, Akira; Yamashita, Kimihiro; Nishi, Masayasu; Takase, Nobuhisa; Hosono, Masayoshi; Nakamura, Tetsu; Suzuki, Satoshi; Kakeji, Yoshihiro
- Abstract
Purpose: The influence of anastomotic leakage on long-term survival in patients with rectal cancer is debatable. The aim of this study was to evaluate relationships between anastomotic leakage and long-term survival. Methods: In this multicenter retrospective cohort study, 395 consecutive stage I to III rectal cancer patients underwent anterior resection between 2007 and 2012. Five-year overall survival, 5-year disease-free survival, and 5-year local recurrence-free survival were compared between patients with leakage (Leakage (+)) and patients without leakage (Leakage (−)). Results: Of 395 patients, 50 (12.7%) had anastomotic leakage. Of these 50, 34 (68.0%) required urgent surgery and 16 (32.0%) could be managed by watchful waiting or with percutaneous drainage. The median follow-up period was 62.6 months. Five-year overall survival did not differ between the two groups (Leakage (+) 93.8% vs. Leakage (−) 89.0%, P = 0.121). Five-year disease-free survival also did not differ between the two groups (81.6% vs. 80.3%, P = 0.731), and neither did 5-year local recurrence-free survival (91.9% vs. 86.1%, P = 0.206). In a multivariable Cox regression model, BMI > 25, preoperative CA19-9 > 37, pathological T stage, pathological N stage, and circumferential resection margin (CRM) positive were independent predictors of disease-free survival. Moreover, pathological T stage, pathological N stage, and CRM positive were the only independent predictors of overall survival and local recurrence-free survival. Anastomotic leakage was not a risk factor for overall survival, disease-free survival, or local recurrence-free survival. Conclusion: Anastomotic leakage is not associated with a significant decrease in long-term survival in rectal cancer patients.
- Subjects
RECTAL cancer; RECTAL surgery; ONCOLOGIC surgery; LEAKAGE; WATCHFUL waiting; PROGRESSION-free survival
- Publication
International Journal of Colorectal Disease, 2020, Vol 35, Issue 7, p1243
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-020-03577-z