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Anastomotic Recurrence After Curative Resection for Colorectal Cancer

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Abstract

Background

A precise understanding of anastomotic recurrence (AR) permits efficient surveillance and treatment strategies. This study aimed to evaluate the clinicopathologic characteristics of patients with AR undergoing curative resection for colorectal cancer (CRC), compare colonic with rectal tumors and investigate the risk factors related to AR.

Methods

A single-institution, retrospective cohort of 9024 patients who underwent curative surgery for CRC between 2000 and 2010 was enrolled. Patients were classified into AR group (n = 53) or non-AR group (n = 8971) and were also characterized by tumor location.

Results

The AR group was independently associated with old age (p = 0.046), advanced N stage (p = 0.003), the rectum (p = 0.001), a large tumor (p = 0.001) and mucinous differentiation (MU) (p = 0.026). In colon cancers, the AR group (n = 20) was independently associated with MU (p = 0.022) and lymphovascular invasion (LVI) (p = 0.001). In rectal cancers, the AR group (n = 33) was independently associated with N2 stage (p = 0.007) and a large tumor (p < 0.001). AR is a burden to patients and physicians because these tumors have a poor prognosis and more advanced pathologic stages than the primary tumors. However, N0 stage and curative resection of an AR tumor (p = 0.001 and p < 0.001, respectively) were found to be independently associated with improved survival in a Cox regression model.

Conclusion

AR is independently associated with the rectum. In colon cancers, MU and LVI are independent risk factors for AR. In rectal cancers, a large tumor and N2 stage are independent risk factors for AR. Although AR shows a poor prognosis, early detection and curative resection may lead to an improved survival.

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Acknowledgments

The authors express their gratitude to Chan Wook Kim, M.D., Ph.D., Jong Lyul Lee, M.D. for their help with the statistical analysis and acquisition of data.

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Authors and Affiliations

  1. Department of Surgery, Haeundae Paik Hospital, College of Medicine, University of Inje, Busan, Republic of Korea

    Won Beom Jung

  2. Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil,Songpa-gu, Seoul, 05505, Republic of Korea

    Chang Sik Yu, Seok Byung Lim, In Ja Park, Yong Sik Yoon & Jin Cheon Kim

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  1. Won Beom Jung
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Correspondence to Chang Sik Yu.

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The authors declare no competing interests in relation to this study.

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Jung, W.B., Yu, C.S., Lim, S.B. et al. Anastomotic Recurrence After Curative Resection for Colorectal Cancer. World J Surg 41, 285–294 (2017). https://doi.org/10.1007/s00268-016-3663-2

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  • DOI: https://doi.org/10.1007/s00268-016-3663-2

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