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Effect of abdominopelvic sepsis on cancer outcome in patients undergoing sphincter saving surgery for rectal cancer
Author(s) -
Van de putte Dirk,
Van Daele Elke,
Willaert Wouter,
Pattyn Piet,
Ceelen Wim,
Van Nieuwenhove Yves
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24706
Subject(s) - medicine , propensity score matching , colorectal cancer , lymphovascular invasion , proportional hazards model , cancer , stage (stratigraphy) , sepsis , pathological , surgery , t stage , oncology , metastasis , paleontology , biology
Background In rectal cancer, the significance of abdominopelvic sepsis (APS) on metastatic tumor growth remains uncertain. We aimed to analyze the effect of abdominopelvic sepsis on long‐term survival in patients undergoing restorative rectal cancer surgery. Methods Data were used from the Belgian PROCARE rectal cancer registry. The effect of abdominopelvic infection on survival was assessed in uni‐ and multivariable Cox regression models. The effect of clinical and pathological covariates was controlled by propensity score‐based matching of cases with controls. The effect of abdominopelvic sepsis on the rate of local and metastatic recurrence was evaluated using crosstabulation and the Pearson χ 2 test. Results In univariable analysis, the presence of APS was associated with significantly worse overall survival (HR 1.3, P = 0.025). After propensity score matching including age, BMI, tumor level, pTstage, pN stage, CRM, tumor grade, number of lymph nodes, and presence of lymphovascular invasion, the association of APS with OS was no longer significant (HR 1.26, 95%CI 0.92‐1.74, P = 0.15). No differences were observed in the risk of local or metastatic recurrence (3.6% vs 2.9% and 13% vs 16.5%). Conclusions In this analysis APS after rectal cancer resection was not significantly associated with OS, metastatic, or local recurrence.