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Locoregional recurrence in patients with anastomotic leakage after anterior resection for rectal carcinoma
Author(s) -
Merkel S.,
Wang W. Y.,
Schmidt O.,
Dworak O.,
Wittekind CH.,
Hohenberger W.,
Hermanek P.
Publication year - 2001
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1046/j.1463-1318.2001.00232.x
Subject(s) - medicine , anastomosis , colorectal cancer , surgery , univariate analysis , multivariate analysis , proportional hazards model , carcinoma , rectal carcinoma , risk factor , complication , cancer
Objective Anastomotic leakage is a serious complication after anterior resection for rectal carcinoma. It is controversial whether anastomotic leakage influences the rate of locoregional recurrence and therefore survival. Patients and methods The data of 940 patients with invasive rectal carcinoma stage I–III treated by curative anterior resection from 1978 to 1996 at the Department of Surgery of the University of Erlangen were analysed. Patients who received neoadjuvant or adjuvant treatment were excluded as well as patients who died postoperatively. 89 out of 814 patients (10.9%) developed an anastomotic leakage after anterior resection. Results The rate of locoregional recurrence during the first five postoperative years of all patients was 13.6%. In patients with anastomotic leakage the rate of locoregional recurrence was 22.0%, significantly higher than in patients without anastomotic leakage which was 12.5%, ( P =0.018). On multivariate Cox regression analysis anastomotic leakage was shown to be an independent risk factor for locoregional recurrence (relative risk: 1.7, CI 95%: 1.02–2.75, P =0.042). Also cancer‐related survival was influenced significantly by anastomotic leakage in univariate analysis as well as in multivariate analysis (relative risk: 1.6, CI 95%: 1.1–2.2, P =0.017). Conclusion Anastomotic leakage after anterior resection for rectal carcinoma is a risk factor for locoregional recurrence and decreases cancer‐related survival.