Impact of anastomotic leakage on outcomes in patients with rectal cancer
https://doi.org/10.17650/2220-3478-2018-8-2-18-23
Abstract
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 % сonfidence 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.
About the Authors
E. G. Rybakov
A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of Russia
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Yu. A. Shelygin
A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of Russia;
Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Russian Federation
2 Salyama Adilya St., 123423 Moscow
M. A. Таraso
A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of Russia
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Russian Federation
2 Salyama Adilya St., 123423 Moscow
M. V. Аlekseev
A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of Russia;
Russian Medical Academy of Postgraduate Education, Ministry of Health of Russia
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Russian Federation
2 Salyama Adilya St., 123423 Moscow
V. N. Kashnikov
A.N. Ryzhikh State Scientific Center of Coloproctology, Ministry of Health of Russia
Russian Federation
2 Salyama Adilya St., 123423 Moscow
Russian Federation
2 Salyama Adilya St., 123423 Moscow
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