Anastomotic Leakage Is Associated with Impaired Overall and Disease-Free Survival after Curative Rectal Cancer Resection: A Propensity Score Analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-10-28

AUTHORS

Yakup Kulu, Ignazio Tarantio, Rene Warschkow, Sandra Kny, Martin Schneider, Bruno M. Schmied, Markus W. Büchler, Alexis Ulrich

ABSTRACT

Background Whether anastomotic leakage (AL) has a negative impact on survival remains a matter of debate. This study aimed to assess the impact of AL on the overall and disease-free survival of patients undergoing curative resection of stages 1–3 rectal cancer using propensity-scoring methods.MethodsIn a single-center study, 570 patients undergoing curative resection of stages 1–3 rectal cancer between January 2002 and December 2011 were assessed. The mean follow-up period was 4.7 ± 2.9 years. Patients who did and did not experience AL were compared using Cox regression and propensity score analyses.ResultsOverall, 51 patients (8.9 %) experienced an AL. The characteristics of the patients were highly biased concerning AL (propensity score, 0.16 ± 0.12 vs. 0.09 ± 0.07; P < 0.001). Anastomotic leakage was uniformly associated with a significantly increased risk of mortality in unadjusted analysis [hazard ratio (HR) 2.30; 95 % confidence interval (CI) 1.40–3.76; P = 0.003], multivariable Cox regression (HR 2.27; 95 % CI 1.33–3.88; P = 0.005), and propensity score-adjusted Cox regression (HR 2.07; 95 % CI 1.21–3.55; P = 0.014). Similarly, disease-free survival was significantly impaired in patients who experienced AL according to unadjusted analysis (HR 1.88; 95 % CI 1.19–2.95; P = 0.011), multivariable Cox regression (HR 1.90; 95 % CI 1.17–3.09; P = 0.014), and propensity score-adjusted Cox regression (HR 2.31; 95 % CI 1.40–3.80; P = 0.002).ConclusionsThis is the first propensity score-based analysis providing evidence that oncologic outcome may be impaired after curative rectal cancer resection in patients with AL. More... »

PAGES

2059-2067

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-014-4187-3

DOI

http://dx.doi.org/10.1245/s10434-014-4187-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1022366699

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25348782


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