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International Journal of Colorectal Disease

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01-07-2020 | Rectal Cancer | Original Article

Does anastomotic leakage after rectal cancer resection worsen long-term oncologic outcome?

Authors: Hiroshi Hasegawa, Takeru Matsuda, Akira Arimoto, Kimihiro Yamashita, Masayasu Nishi, Nobuhisa Takase, Masayoshi Hosono, Tetsu Nakamura, Satoshi Suzuki, Yoshihiro Kakeji

Published in: International Journal of Colorectal Disease | Issue 7/2020

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.

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Title: Does anastomotic leakage after rectal cancer resection worsen long-term oncologic outcome?
Authors: Hiroshi Hasegawa
Takeru Matsuda
Akira Arimoto
Kimihiro Yamashita
Masayasu Nishi
Nobuhisa Takase
Masayoshi Hosono
Tetsu Nakamura
Satoshi Suzuki
Yoshihiro Kakeji
Publication date: 01-07-2020
Publisher: Springer Berlin Heidelberg
Keywords: Rectal Cancer
Rectal Cancer
Published in: International Journal of Colorectal Disease / Issue 7/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-020-03577-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Does anastomotic leakage after rectal cancer resection worsen long-term oncologic outcome?

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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