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.
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.
Authors: Megan M Garrity; Lawrence J Burgart; Michelle R Mahoney; Harold E Windschitl; Muhammad Salim; Martin Wiesenfeld; James E Krook; John C Michalak; Richard M Goldberg; Michael J O'Connell; Alfred F Furth; Daniel J Sargent; Linda M Murphy; Eunice Hill; Darren L Riehle; Cecelia H Meyers; Thomas E Witzig Journal: J Clin Oncol Date: 2004-05-01 Impact factor: 44.544
Authors: Kenneth G Walker; Stephen W Bell; Matthew J F X Rickard; Daniel Mehanna; Owen F Dent; Pierre H Chapuis; E Leslie Bokey Journal: Ann Surg Date: 2004-08 Impact factor: 12.969
Authors: P Sánchez-Velázquez; M Pera; M Jiménez-Toscano; X Mayol; X Rogés; L Lorente; M Iglesias; M Gallén Journal: Clin Transl Oncol Date: 2018-04-05 Impact factor: 3.405
Authors: Steven Oosterling; Hein Stockmann; Gerben van der Bij; Eric Belt; Marjolein van Egmond Journal: J Gastrointest Surg Date: 2011-07-14 Impact factor: 3.452
Authors: E J T Belt; H B A C Stockmann; G S A Abis; J M de Boer; E S M de Lange-de Klerk; M van Egmond; G A Meijer; S J Oosterling Journal: J Gastrointest Surg Date: 2012-10-24 Impact factor: 3.452
Authors: N Nakayama; K Yamashita; T Tanaka; H Kawamata; A Ooki; T Sato; T Nakamura; M Watanabe Journal: Clin Exp Metastasis Date: 2015-11-12 Impact factor: 5.150