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International Journal of Colorectal Disease

, Volume 30, Issue 12, pp 1667–1675 | Cite as

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

  • Sabrina M. Ebinger
  • René Warschkow
  • Ignazio Tarantino
  • Bruno M. Schmied
  • Lukas MartiEmail author
Original Article

Abstract

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 5.2 years for all patients; and 7.4 years 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.

Keywords

Rectal cancer resection Anastomotic leackage Overall survival Cancer-specific survival Propensity score matching 

Notes

Conflict of interest

The authors declare that they have no competing interests.

Compliance with ethical standards

For this type of study formal consent is not required. However all patients agreed that their data may be used for scientific analyses on a general consenting form, when they entered the hospital. These proceedings were generally approved by the local ethic board.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Sabrina M. Ebinger
    • 1
  • René Warschkow
    • 1
    • 2
  • Ignazio Tarantino
    • 3
  • Bruno M. Schmied
    • 1
  • Lukas Marti
    • 1
    • 4
    Email author
  1. 1.Department of SurgeryCantonal Hospital of St. GallenSt. GallenSwitzerland
  2. 2.Institute of Medical Biometry and InformaticsUniversity of HeidelbergHeidelbergGermany
  3. 3.Department of SurgeryUniversity of HeidelbergHeidelbergGermany
  4. 4.Department of Surgery, University-Hospital Mannheim, Medical Faculty MannheimUniversity of HeidelbergMannheimGermany

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