Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer

Gyoung Tae Noh, Yeo Shen Ann, Chinock Cheong, Jeonghee Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Namkyu Kim

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Abstract

Anastomotic leakage (AL) is a well-known cause of morbidity after low anterior resection (LAR) for rectal cancer, but its impact on oncologic outcome is not well understood. The aim of this study is to investigate the impact of AL on long-term oncologic outcome and to identify factors associated with AL that may affect prognosis after LAR for rectal cancer. A retrospective analysis of patients who underwent curative resection for rectal cancer without diverting stoma was performed. To investigate AL related factors that may be associated with oncologic outcome, Clavien-Dindo grades, prognostic nutritional indices (PNI) and inflammatory indices were included. One hundred and one patients out of a total of 1258 patients developed postoperative AL, giving an AL rate of 8.0%. Patients with AL showed poorer disease-free survival (DFS), than patients without AL (hazard ratio [HR] = 1.6; 95% confidence intervals [CI]: 1.1-2.5; P = 0.01). In patients who developed AL, age over 60 (HR = 2.2; 95% CI: 1.1-4.7; P = 0.033), advanced pathologic stage (HR = 2.4; 95% CI: 1.4-4.0; P = 0.001), suppressed neutrophil-proportion (≤80%) (HR = 2.6; 95% CI: 1.2-5.8; P = 0.019) and PNI <36 (HR = 3.5; 95% CI: 1.2-9.6; P = 0.018) were associated with poorer DFS. AL was associated with poorer DFS. In patients with AL, a suppressed neutrophil-proportion and decreased PNI below 36 were associated with tumor recurrence.

Original languageEnglish
Article number52
JournalMedicine (United States)
Volume95
Issue number30
DOIs
Publication statusPublished - 2016 Jul 1

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Anastomotic Leak
Rectal Neoplasms
Nutrition Assessment
Confidence Intervals
Disease-Free Survival
Neutrophils

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Noh, Gyoung Tae ; Ann, Yeo Shen ; Cheong, Chinock ; Han, Jeonghee ; Cho, Min Soo ; Hur, Hyuk ; Min, Byung Soh ; Lee, Kang Young ; Kim, Namkyu. / Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer. In: Medicine (United States). 2016 ; Vol. 95, No. 30.
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abstract = "Anastomotic leakage (AL) is a well-known cause of morbidity after low anterior resection (LAR) for rectal cancer, but its impact on oncologic outcome is not well understood. The aim of this study is to investigate the impact of AL on long-term oncologic outcome and to identify factors associated with AL that may affect prognosis after LAR for rectal cancer. A retrospective analysis of patients who underwent curative resection for rectal cancer without diverting stoma was performed. To investigate AL related factors that may be associated with oncologic outcome, Clavien-Dindo grades, prognostic nutritional indices (PNI) and inflammatory indices were included. One hundred and one patients out of a total of 1258 patients developed postoperative AL, giving an AL rate of 8.0{\%}. Patients with AL showed poorer disease-free survival (DFS), than patients without AL (hazard ratio [HR] = 1.6; 95{\%} confidence intervals [CI]: 1.1-2.5; P = 0.01). In patients who developed AL, age over 60 (HR = 2.2; 95{\%} CI: 1.1-4.7; P = 0.033), advanced pathologic stage (HR = 2.4; 95{\%} CI: 1.4-4.0; P = 0.001), suppressed neutrophil-proportion (≤80{\%}) (HR = 2.6; 95{\%} CI: 1.2-5.8; P = 0.019) and PNI <36 (HR = 3.5; 95{\%} CI: 1.2-9.6; P = 0.018) were associated with poorer DFS. AL was associated with poorer DFS. In patients with AL, a suppressed neutrophil-proportion and decreased PNI below 36 were associated with tumor recurrence.",
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Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer. / Noh, Gyoung Tae; Ann, Yeo Shen; Cheong, Chinock; Han, Jeonghee; Cho, Min Soo; Hur, Hyuk; Min, Byung Soh; Lee, Kang Young; Kim, Namkyu.

In: Medicine (United States), Vol. 95, No. 30, 52, 01.07.2016.

Research output: Contribution to journalArticle

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T1 - Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer

AU - Noh, Gyoung Tae

AU - Ann, Yeo Shen

AU - Cheong, Chinock

AU - Han, Jeonghee

AU - Cho, Min Soo

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Lee, Kang Young

AU - Kim, Namkyu

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AB - Anastomotic leakage (AL) is a well-known cause of morbidity after low anterior resection (LAR) for rectal cancer, but its impact on oncologic outcome is not well understood. The aim of this study is to investigate the impact of AL on long-term oncologic outcome and to identify factors associated with AL that may affect prognosis after LAR for rectal cancer. A retrospective analysis of patients who underwent curative resection for rectal cancer without diverting stoma was performed. To investigate AL related factors that may be associated with oncologic outcome, Clavien-Dindo grades, prognostic nutritional indices (PNI) and inflammatory indices were included. One hundred and one patients out of a total of 1258 patients developed postoperative AL, giving an AL rate of 8.0%. Patients with AL showed poorer disease-free survival (DFS), than patients without AL (hazard ratio [HR] = 1.6; 95% confidence intervals [CI]: 1.1-2.5; P = 0.01). In patients who developed AL, age over 60 (HR = 2.2; 95% CI: 1.1-4.7; P = 0.033), advanced pathologic stage (HR = 2.4; 95% CI: 1.4-4.0; P = 0.001), suppressed neutrophil-proportion (≤80%) (HR = 2.6; 95% CI: 1.2-5.8; P = 0.019) and PNI <36 (HR = 3.5; 95% CI: 1.2-9.6; P = 0.018) were associated with poorer DFS. AL was associated with poorer DFS. In patients with AL, a suppressed neutrophil-proportion and decreased PNI below 36 were associated with tumor recurrence.

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