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Journal of Gastrointestinal Surgery

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01-01-2011 | Original Article

Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer

Authors: Hiroshi Katoh, Keishi Yamashita, Guoqin Wang, Takeo Sato, Takatoshi Nakamura, Masahiko Watanabe

Published in: Journal of Gastrointestinal Surgery | Issue 1/2011

Abstract

Purpose

In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.

Methods

Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.

Results

The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (P = 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21, P = 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (P = 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (P = 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70, P = 0.075).

Conclusions

The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC.

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Title: Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer
Authors: Hiroshi Katoh
Keishi Yamashita
Guoqin Wang
Takeo Sato
Takatoshi Nakamura
Masahiko Watanabe
Publication date: 01-01-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 1/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-010-1379-4

At a glance: The STEP trials

Springer Medicine

Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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