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Anastomotic leakage after curative rectal cancer resection has no impact on long-term survival: a propensity score analysis

Ebinger, Sabrina ; Warschkow, René ; Tarantino, Ignazio ; Schmied, Bruno ; Marti, Lukas

In: International Journal of Colorectal Disease, 2015, vol. 30, no. 12, p. 1667-1675

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    Titel
    • Anastomotic leakage after curative rectal cancer resection has no impact on long-term survival: a propensity score analysis
    Autor
    • Ebinger, Sabrina. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland
    • Warschkow, René. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland
    • Tarantino, Ignazio. Department of Surgery, University of Heidelberg, 69120, Heidelberg, Germany
    • Schmied, Bruno. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland
    • Marti, Lukas. Department of Surgery, Cantonal Hospital of St. Gallen, 9007, St. Gallen, Switzerland
    Dokumententyp
    • Postprint
    Sprache
    • Englisch
    Veröffentlicht in
    • International Journal of Colorectal Disease, 2015, vol. 30, no. 12, p. 1667-1675. Springer Berlin Heidelberg
    Andere elektronische Ausgabe
    OAI-PMH-ID
    • oai:doc.rero.ch:331291
    Summary
    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 5.2years for all patients; and 7.4years 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.