Preoperative chemoradiotherapy effects on anastomotic leakage after rectal cancer resection: A propensity score matching analysis

Jee Suk Chang, Ki Chang Keum, Namkyu Kim, Seung Hyuk Baik, Byung So Min, Hyuk Huh, Chang Geol Lee, Woong Sub Koom

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19 Citations (Scopus)

Abstract

OBJECTIVE:: To assess the effects of preoperative chemoradiotherapy (CRT) on anastomotic leakage (AL) after rectal cancer resection, using propensity score matching. BACKGROUND:: Conflicting data have emerged over the last decade regarding the effect of preoperative CRT on AL. METHODS:: We reviewed 1437 consecutive patients with rectal cancer who underwent low anterior resection (LAR) at our institution between 2005 and 2012. AL evaluated as grade C was the primary endpoint, as proposed by the International Study Group of Rectal Cancer in 2010. The patients were treated with (n = 360) or without (n = 1077) preoperative CRT. The total radiation dose was 50.4 Gy in 28 fractions. Multivariate and propensity score matching analyses were used to compensate for the differences in some baseline characteristics. RESULTS:: The preoperative CRT group contained more patients with the following characteristics, older age, male sex, smoker, advanced stage tumor, lower/mid rectal tumor location, ultra-LAR, and diverting stoma, than the non-preoperative CRT group (all Ps < 0.05). Postoperative AL occurred in 91 patients (6.3%). Before propensity score matching, the incidence of AL in patients with or without preoperative CRT was 7.5% and 5.9%, respectively (P = 0.293). After propensity score matching, the 2 groups were nearly balanced except for the initial stage and the length of the surgeonÊ's career, and the incidence of AL in patients with or without preoperative CRT was 7.5% and 8.1%, respectively (P = 0.781). CONCLUSIONS:: We did not observe that preoperative CRT increased the risk of postoperative AL after LAR in patients with rectal cancer, using propensity score matching analysis.

Original languageEnglish
Pages (from-to)516-521
Number of pages6
JournalAnnals of Surgery
Volume259
Issue number3
DOIs
Publication statusPublished - 2014 Mar 1

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Propensity Score
Anastomotic Leak
Chemoradiotherapy
Rectal Neoplasms
Incidence
Radiation

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Chang, Jee Suk ; Keum, Ki Chang ; Kim, Namkyu ; Baik, Seung Hyuk ; Min, Byung So ; Huh, Hyuk ; Lee, Chang Geol ; Koom, Woong Sub. / Preoperative chemoradiotherapy effects on anastomotic leakage after rectal cancer resection : A propensity score matching analysis. In: Annals of Surgery. 2014 ; Vol. 259, No. 3. pp. 516-521.
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abstract = "OBJECTIVE:: To assess the effects of preoperative chemoradiotherapy (CRT) on anastomotic leakage (AL) after rectal cancer resection, using propensity score matching. BACKGROUND:: Conflicting data have emerged over the last decade regarding the effect of preoperative CRT on AL. METHODS:: We reviewed 1437 consecutive patients with rectal cancer who underwent low anterior resection (LAR) at our institution between 2005 and 2012. AL evaluated as grade C was the primary endpoint, as proposed by the International Study Group of Rectal Cancer in 2010. The patients were treated with (n = 360) or without (n = 1077) preoperative CRT. The total radiation dose was 50.4 Gy in 28 fractions. Multivariate and propensity score matching analyses were used to compensate for the differences in some baseline characteristics. RESULTS:: The preoperative CRT group contained more patients with the following characteristics, older age, male sex, smoker, advanced stage tumor, lower/mid rectal tumor location, ultra-LAR, and diverting stoma, than the non-preoperative CRT group (all Ps < 0.05). Postoperative AL occurred in 91 patients (6.3{\%}). Before propensity score matching, the incidence of AL in patients with or without preoperative CRT was 7.5{\%} and 5.9{\%}, respectively (P = 0.293). After propensity score matching, the 2 groups were nearly balanced except for the initial stage and the length of the surgeon{\^E}'s career, and the incidence of AL in patients with or without preoperative CRT was 7.5{\%} and 8.1{\%}, respectively (P = 0.781). CONCLUSIONS:: We did not observe that preoperative CRT increased the risk of postoperative AL after LAR in patients with rectal cancer, using propensity score matching analysis.",
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Preoperative chemoradiotherapy effects on anastomotic leakage after rectal cancer resection : A propensity score matching analysis. / Chang, Jee Suk; Keum, Ki Chang; Kim, Namkyu; Baik, Seung Hyuk; Min, Byung So; Huh, Hyuk; Lee, Chang Geol; Koom, Woong Sub.

In: Annals of Surgery, Vol. 259, No. 3, 01.03.2014, p. 516-521.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative chemoradiotherapy effects on anastomotic leakage after rectal cancer resection

T2 - A propensity score matching analysis

AU - Chang, Jee Suk

AU - Keum, Ki Chang

AU - Kim, Namkyu

AU - Baik, Seung Hyuk

AU - Min, Byung So

AU - Huh, Hyuk

AU - Lee, Chang Geol

AU - Koom, Woong Sub

PY - 2014/3/1

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N2 - OBJECTIVE:: To assess the effects of preoperative chemoradiotherapy (CRT) on anastomotic leakage (AL) after rectal cancer resection, using propensity score matching. BACKGROUND:: Conflicting data have emerged over the last decade regarding the effect of preoperative CRT on AL. METHODS:: We reviewed 1437 consecutive patients with rectal cancer who underwent low anterior resection (LAR) at our institution between 2005 and 2012. AL evaluated as grade C was the primary endpoint, as proposed by the International Study Group of Rectal Cancer in 2010. The patients were treated with (n = 360) or without (n = 1077) preoperative CRT. The total radiation dose was 50.4 Gy in 28 fractions. Multivariate and propensity score matching analyses were used to compensate for the differences in some baseline characteristics. RESULTS:: The preoperative CRT group contained more patients with the following characteristics, older age, male sex, smoker, advanced stage tumor, lower/mid rectal tumor location, ultra-LAR, and diverting stoma, than the non-preoperative CRT group (all Ps < 0.05). Postoperative AL occurred in 91 patients (6.3%). Before propensity score matching, the incidence of AL in patients with or without preoperative CRT was 7.5% and 5.9%, respectively (P = 0.293). After propensity score matching, the 2 groups were nearly balanced except for the initial stage and the length of the surgeonÊ's career, and the incidence of AL in patients with or without preoperative CRT was 7.5% and 8.1%, respectively (P = 0.781). CONCLUSIONS:: We did not observe that preoperative CRT increased the risk of postoperative AL after LAR in patients with rectal cancer, using propensity score matching analysis.

AB - OBJECTIVE:: To assess the effects of preoperative chemoradiotherapy (CRT) on anastomotic leakage (AL) after rectal cancer resection, using propensity score matching. BACKGROUND:: Conflicting data have emerged over the last decade regarding the effect of preoperative CRT on AL. METHODS:: We reviewed 1437 consecutive patients with rectal cancer who underwent low anterior resection (LAR) at our institution between 2005 and 2012. AL evaluated as grade C was the primary endpoint, as proposed by the International Study Group of Rectal Cancer in 2010. The patients were treated with (n = 360) or without (n = 1077) preoperative CRT. The total radiation dose was 50.4 Gy in 28 fractions. Multivariate and propensity score matching analyses were used to compensate for the differences in some baseline characteristics. RESULTS:: The preoperative CRT group contained more patients with the following characteristics, older age, male sex, smoker, advanced stage tumor, lower/mid rectal tumor location, ultra-LAR, and diverting stoma, than the non-preoperative CRT group (all Ps < 0.05). Postoperative AL occurred in 91 patients (6.3%). Before propensity score matching, the incidence of AL in patients with or without preoperative CRT was 7.5% and 5.9%, respectively (P = 0.293). After propensity score matching, the 2 groups were nearly balanced except for the initial stage and the length of the surgeonÊ's career, and the incidence of AL in patients with or without preoperative CRT was 7.5% and 8.1%, respectively (P = 0.781). CONCLUSIONS:: We did not observe that preoperative CRT increased the risk of postoperative AL after LAR in patients with rectal cancer, using propensity score matching analysis.

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