Journal of Gastrointestinal Surgery

, Volume 15, Issue 1, pp 120–129

Anastomotic Leakage Contributes to the Risk for Systemic Recurrence in Stage II Colorectal Cancer

  • Hiroshi Katoh
  • Keishi Yamashita
  • Guoqin Wang
  • Takeo Sato
  • Takatoshi Nakamura
  • Masahiko Watanabe
Original Article

Abstract

Purpose

In stage II colorectal cancer (CRC), high-risk patient selection is required, but no candidate markers have been elucidated. Our concern was whether anastomotic leakage (Lk) is a potential available clinicopathological factor for selecting high-risk stage II.

Methods

Two hundred seven patients with stage II CRC who underwent curative resection were analyzed. Clinical variables were tested for their relationship to survival.

Results

The 5-year disease-free survival rate (DFS) was 87.0%. The univariable prognostic analyses indicated that Lk (P = 0.003) was the only significant factor. The multivariable prognostic analysis revealed that Lk remained to be potently independent [hazard ratio (HR), 4.21, P = 0.021), and the DFS was 58.3% in cases with Lk, while 88.7% in the counterpart. The multivariable logistic regression analysis revealed perioperative blood transfusion (P = 0.001) was independently associated with Lk. Intriguingly, Lk was closely associated with hematogenic recurrence (P = 0.003) rather than peritoneal or local recurrence. Although sustained increase of the serum C-reactive protein at 2 weeks after operation predicted poor prognosis, the mutitivariable analysis including the C-reactive protein level revealed that Lk still indicated the prognostic potential (HR, 3.70, P = 0.075).

Conclusions

The findings concluded that Lk may be a high risk for systemic recurrence in stage II CRC.

Keywords

Colorectal cancer Stage II Prognosis Anastomotic leakage 

Supplementary material

11605_2010_1379_MOESM1_ESM.pdf (200 kb)
High-resolution image (PDF 200 kb)
11605_2010_1379_MOESM2_ESM.pdf (200 kb)
High-resolution image (PDF 200 kb)
11605_2010_1379_MOESM3_ESM.xls (14 kb)
Supplemental Table 1Diagnostic details of the patients with anastomotic leakage (XLS 14.5 kb)
11605_2010_1379_MOESM4_ESM.xls (46 kb)
Supplemental Table 2Correlation between CRP and clinicopathological factors in stage II patients (XLS 46.0 kb)

Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Hiroshi Katoh
    • 1
  • Keishi Yamashita
    • 1
  • Guoqin Wang
    • 2
  • Takeo Sato
    • 1
  • Takatoshi Nakamura
    • 1
  • Masahiko Watanabe
    • 1
  1. 1.Department of SurgeryKitasato University School of MedicineSagamiharaJapan
  2. 2.Department on Community-Based Perinatal and Emergency Medicine, Kitasato Clinical Research CenterKitasato University School of MedicineTokyoJapan

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