Sabrina M Ebinger1, René Warschkow1,2, Ignazio Tarantino3, Bruno M Schmied1, Lukas Marti4,5. 1. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland. 2. Institute of Medical Biometry and Informatics, University of Heidelberg, 69120, Heidelberg, Germany. 3. Department of Surgery, University of Heidelberg, 69120, Heidelberg, Germany. 4. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland. Lukas.Marti@kssg.ch. 5. Department of Surgery, University-Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, 68167, Mannheim, Germany. Lukas.Marti@kssg.ch.
Abstract
PURPOSE: Anastomotic leakage (AL) is a severe and frequent complication of rectal cancer resection, with an incidence rate of approximately 9 %. Although the impact of AL on morbidity and short-term mortality has been established, the literature is contradictory regarding its influence on long-term, cancer-specific survival. The present investigation assessed the long-term survival of 584 patients with stage I-III rectal cancer. METHODS: The 10-year overall survival and cancer-specific survival were analyzed in 584 patients from a single tertiary center. All patients had undergone curative rectal cancer resection between 1991 and 2010. Patients with and without AL were compared using both a multivariate Cox hazards model and propensity score analysis. RESULTS: A total of 64 patients developed AL (11.0 %, 95 % confidence interval (CI) = 8.7 to 13.8 %). The median follow-up was 5.2 years for all patients; and 7.4 years for patients still alive at the end of the investigated period. AL did persistently not impair cancer-specific survival based on unadjusted Cox regression (hazard ratio of death (HR) = 1.27, 95 % CI = 0.65 to 2.48, P = 0.489); risk-adjusted Cox regression (HR = 1.10, 95 % CI = 0.54 to 2.20, P = 0.799); and propensity score matching (HR = 1.18, 95 % CI = 0.57 to 2.43, P = 0.660). CONCLUSIONS: Based on the present propensity score analysis, the oncologic outcomes in patients undergoing curative rectal cancer resections were not impaired by the development of anastomotic leakage.
PURPOSE:Anastomotic leakage (AL) is a severe and frequent complication of rectal cancer resection, with an incidence rate of approximately 9 %. Although the impact of AL on morbidity and short-term mortality has been established, the literature is contradictory regarding its influence on long-term, cancer-specific survival. The present investigation assessed the long-term survival of 584 patients with stage I-III rectal cancer. METHODS: The 10-year overall survival and cancer-specific survival were analyzed in 584 patients from a single tertiary center. All patients had undergone curative rectal cancer resection between 1991 and 2010. Patients with and without AL were compared using both a multivariate Cox hazards model and propensity score analysis. RESULTS: A total of 64 patients developed AL (11.0 %, 95 % confidence interval (CI) = 8.7 to 13.8 %). The median follow-up was 5.2 years for all patients; and 7.4 years for patients still alive at the end of the investigated period. AL did persistently not impair cancer-specific survival based on unadjusted Cox regression (hazard ratio of death (HR) = 1.27, 95 % CI = 0.65 to 2.48, P = 0.489); risk-adjusted Cox regression (HR = 1.10, 95 % CI = 0.54 to 2.20, P = 0.799); and propensity score matching (HR = 1.18, 95 % CI = 0.57 to 2.43, P = 0.660). CONCLUSIONS: Based on the present propensity score analysis, the oncologic outcomes in patients undergoing curative rectal cancer resections were not impaired by the development of anastomotic leakage.
Authors: Sang Hun Jung; Chang Sik Yu; Pyong Wha Choi; Dae Dong Kim; In Ja Park; Hee Cheol Kim; Jin Cheon Kim Journal: Dis Colon Rectum Date: 2008-04-12 Impact factor: 4.585
Authors: H S Snijders; M W J M Wouters; N J van Leersum; N E Kolfschoten; D Henneman; A C de Vries; R A E M Tollenaar; B A Bonsing Journal: Eur J Surg Oncol Date: 2012-09-03 Impact factor: 4.424
Authors: Rene Warschkow; Ulrich Güller; Dieter Köberle; Sascha A Müller; Thomas Steffen; Martin Thurnheer; Bruno M Schmied; Ignazio Tarantino Journal: Ann Surg Date: 2014-01 Impact factor: 12.969
Authors: M den Dulk; C A M Marijnen; L Collette; H Putter; L Påhlman; J Folkesson; J-F Bosset; C Rödel; K Bujko; C J H van de Velde Journal: Br J Surg Date: 2009-09 Impact factor: 6.939
Authors: Gyoung Tae Noh; Yeo Shen Ann; Chinock Cheong; Jeonghee Han; Min Soo Cho; Hyuk Hur; Byung Soh Min; Kang Young Lee; Nam Kyu Kim Journal: Medicine (Baltimore) Date: 2016-07 Impact factor: 1.889
Authors: Melissa N N Arron; Nynke G Greijdanus; Sarah Bastiaans; Pauline A J Vissers; Rob H A Verhoeven; Richard P G Ten Broek; Henk M W Verheul; Pieter J Tanis; Harry van Goor; Johannes H W de Wilt Journal: Ann Surg Date: 2022-08-05 Impact factor: 13.787
Authors: Edgar J B Furnée; Tjeerd S Aukema; Steven J Oosterling; Wernard A A Borstlap; Willem A Bemelman; Pieter J Tanis Journal: J Gastrointest Surg Date: 2018-09-05 Impact factor: 3.452