Open AccessImpact of anastomotic leakage on outcomes in patients with rectal cancer
Author(s) -
Е. Г. Рыбаков,
Yu. A. Shelygin,
M. A. Таraso,
М. В. Алексеев,
В. Н. Кашников
Publication year - 2018
Publication title -
onkologičeskaâ koloproktologiâ
Language(s) - English
Resource type - Journals
eISSN - 2413-0583
pISSN - 2220-3478
DOI - 10.17650/2220-3478-2018-8-2-18-23
Subject(s) - medicine , hazard ratio , colorectal cancer , stage (stratigraphy) , logistic regression , proportional hazards model , confidence interval , surgery , anastomosis , gastroenterology , cancer , paleontology , biology
Background. The effect of anastomotic leakage (AL) on oncological outcomes after total mesorectumectomy is controversial.Objective: to investigate the influence of AL and other factors on oncological outcome.Materials and methods. Data of 67 patients underwent total mesorectumectomy with normal healing were compared with those for 16 patients who experienced AL. Long-term oncological outcomes were analysed.Results. Median follow-up was 43 months. AL rate was 19.4 % (16 cases out of 83). Following factors had negative influence on lower 4-year disease-free survival rate and reached statistical significance in univariant analysis: tumor invasion (hazard ratio (HR) 8.8; 95 % с onfidence interval (CI) 1.4–13.7; р = 0.01), metastases in regional lymph nodes (HR 3.5; 95 % CI 1.2–12.3; р = 0.03), tumor stage (р = 0.048), level of tumor differentiation (HR 0.1; 95 % CI 0–0.6; р <0.0001), tumor stenosis (HR 8.8; 95 % CI 1.4–13.7; р = 0.002), AL (HR 3.9; 95 % CI 1.6–37.1; р = 0.01). In the logistic regression analysis independent risk factors for the development of recurrence were not revealed.Conclusion. AL was not proved to be a risk factor of worse oncological outcome. Hence, additional adjuvant treatment or extended follow-up on the basis of the occurrence of AL after low anterior resection of rectal cancer might not be justified.