Anastomotic leakage after surgery for rectal cancer: a risk factor for local recurrence, distant metastasis and reduced cancer-specific survival?

2011 ◽  
Vol 13 (3) ◽  
pp. 272-283 ◽  
Author(s):  
F. Jörgren ◽  
R. Johansson ◽  
L. Damber ◽  
G. Lindmark
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Local Recurrence ◽  
Anastomotic Leakage ◽  
Distant Metastasis ◽  
Cancer Specific Survival

scholarly journals The risk factors of local recurrence and distant metastasis on pT1/T2N0 mid-low rectal cancer after total mesorectal excision

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
I-Li Lai ◽  
Jeng-Fu You ◽  
Yih-Jong Chern ◽  
Wen-Sy Tsai ◽  
Jy-Ming Chiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Resection Margin ◽  
Radical Resection ◽  
Hazard Ratio ◽  
Low Rectal Cancer ◽  
Distal Resection Margin ◽  
Lymph Node Yield

Abstract Background Radical resection is associated with good prognosis among patients with cT1/T2Nx rectal cancer. However, still some of the patients experienced cancer recurrence following radical resection. This study tried to identify the postoperative risk factors of local recurrence and distant metastasis separately. Methods This retrospective, single-center study comprised of 279 consecutive patients from Linkou branch of Chang Gung Memorial Hospital in 2005–2016 with rectal adenocarcinoma, pT1/T2N0M0 at distance from anal verge ≤ 8cm, who received curative radical resection. Results The study included 279 patients with pT1/pT2N0 mid-low rectal cancer with median follow-up of 73.5 months. Nineteen (6.8%) patients had disease recurrence in total. Nine (3.2%) of them had local recurrence, and fourteen (5.0%) of them had distant metastasis. Distal resection margin < 0.9 (cm) (hazard ratio = 4.9, p = 0.050) was the risk factor of local recurrence. Preoperative carcinoembryonic antigen (CEA) ≥ 5 ng/mL (hazard ratio = 9.3, p = 0.0003), lymph node yield (LNY) < 14 (hazard ratio = 5.0, p = 0.006), and distal resection margin < 1.4cm (hazard ratio = 4.0, p = 0.035) were the risk factors of distant metastasis. Conclusion For patients with pT1/pT2N0 mid-low rectal cancer, current multidisciplinary treatment brings acceptable survival outcome. Insufficient distal resection margin attracted the awareness of risk factors for local recurrence and distant metastasis as a foundation for future research.

scholarly journals Leakage after Surgery for Rectum Cancer: Inconsistency in Reporting to the Danish Colorectal Cancer Group

2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
L. Borly ◽  
M. B. Ellebæk ◽  
N. Qvist
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Leakage Rate ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Prognostic Impact ◽  
Cancer Specific Survival ◽  
Cancer Group ◽  
Core Questions

Purpose. Anastomotic leakage accounts for up to 1/3 of all fatalities after rectal cancer surgery. Evidence suggests that anastomotic leakage has a negative prognostic impact on local cancer recurrence and long-term cancer specific survival. The reported leakage rate in 2011 in Denmark varied from 7 to 45 percent. The objective was to clarify if the reporting of anastomotic leakage to the Danish Colorectal Cancer Group was rigorous and unequivocal.Methods. An Internet-based questionnaire was e-mailed to all Danish surgical departments, who reported to Danish Colorectal Cancer Group (DCCG) in 2011. There were 23 questions. Four core questions were whether pelvic collection, fecal appearance in a pelvic drain, rectovaginal fistula, and “watchfull” waiting patients were reported as anastomotic leakage.Results. Fourteen out of 17 departments, who in 2011 according to DDCG performed rectal cancer surgery, answered the questionnaire. This gave a response rate of 82%. In three of four core questions there was disagreement in what should be reported as anastomotic leakage.Conclusion. The reporting of anastomotic leakage to the Danish Colorectal Cancer Group was not rigorous and unequivocal. The reported anastomotic leakage rate in Danish Colorectal Cancer Group should be interpreted with caution.

scholarly journals Distant Metastasis in Colorectal Cancer is a Risk Factor for Anastomotic Leakage

2015 ◽  
Vol 23 (3) ◽  
pp. 888-893 ◽  
Author(s):  
Samuel A. Käser ◽  
Diana Mattiello ◽  
Christoph A. Maurer
Keyword(s):  
Colorectal Cancer ◽  
Risk Factor ◽  
Anastomotic Leakage ◽  
Distant Metastasis

scholarly journals Sphincter-Sparing Surgery in Patients with Mid and Low Rectal Cancer - Risk Factors for Local Recurrence and Anastomotic Leakage

Chirurgia ◽  
2016 ◽  
Vol 111 (6) ◽  
pp. 481 ◽  
Author(s):  
Denis Aslan ◽  
Florin Grama ◽  
Daniel Cristian ◽  
Adrian Bordea ◽  
Traean Burcos
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Local Recurrence ◽  
Cancer Risk ◽  
Anastomotic Leakage ◽  
Low Rectal Cancer ◽  
Cancer Risk Factors

scholarly journals The importance of training and education in performing total mesorectal excision in rectal cancer surgery

2017 ◽  
Vol 74 (4) ◽  
pp. 349-353
Author(s):  
Tomislav Petrovic ◽  
Ferenc Vicko ◽  
Dragana Radovanovic ◽  
Nemanja Petrovic ◽  
Milan Ranisavljevic ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Surgical Treatment ◽  
Local Recurrence ◽  
Anastomotic Leakage ◽  
New Technologies ◽  
Surgical Techniques ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Significant Difference ◽  
Duration Of Surgery

Background/Aim. In the last two decades there has been a significant progress in rectal cancer surgery. Preoperative radiotherapy, the introduction of staplers and largely improved surgical techniques have greatly contributed to better treatment outcomes, primarily by reducing the frequency of early surgical complications and the rate of local recurrence. The aim of this study was to compare operative and postoperative results in the treatment of rectal cancer between the two groups of surgeons ? those who are closely engaged in colorectal surgery and those who deal with these issues sporadically. Methods. This retrospective study included 146 patients who had underwent rectal cancer surgery at the Institute of Oncology of Vojvodina in the period from January 1, 2008 to December 31, 2010. The patients were divided into two groups, the group N1 of 101 patients operated on by trained colorectal surgeons, and the group N2 of 45 patients operated on by surgeons without training in totalmesorectal excision (TME). Results. Preoperative chemoradiotherapy was received by 49 (33.56%) of the patients. A statistically significant difference between the two groups was noted in the duration of surgery and the need for blood transfusion during surgery. Anastomotic leakage occurred in 3 patients from the group N1 and in 10 patients from the group N2. Seven (4.79%) of the patients developed local recurrence after surgical treatment. There were significant differences in local recurrence rate and anastomotic leakage rate between the compared groups. Conclusion. It is necessary to continue education and training in surgery for rectal cancer to master new technologies and surgical techniques and to improve the results of surgical treatment.

Active lymphangiogenesis is a major risk factor for anastomotic leakage following sphincter-sparing resection of rectal cancer

2011 ◽  
Vol 104 (5) ◽  
pp. 493-498 ◽  
Author(s):  
Weirong Chen ◽  
Yanchon Li ◽  
Ziqun Liao ◽  
Guangrong Lin ◽  
Gaoyang Cai ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Anastomotic Leakage ◽  
Major Risk Factor

The Aortic Calcification Index is a risk factor associated with anastomotic leakage after anterior resection of rectal cancer

2019 ◽  
Vol 21 (12) ◽  
pp. 1397-1404 ◽  
Author(s):  
Z. Shen ◽  
Y. An ◽  
Y. Shi ◽  
M. Yin ◽  
Q. Xie ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Risk Factor ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Aortic Calcification

scholarly journals Influence of Body Mass Index on Long-Term Outcome in Patients with Rectal Cancer—A Single Centre Experience

Cancers ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 609 ◽  
Author(s):  
Kalb ◽  
Langheinrich ◽  
Merkel ◽  
Krautz ◽  
Brunner ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Rectal Cancer ◽  
Overall Survival ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Hazard Ratio ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Obesity Class

Background: Excess bodyweight is known to influence the risk of colorectal cancer; however, little evidence exists for the influence of the body mass index (BMI) on the long-term outcome of patients with rectal cancer. Methods: We assessed the impact of the BMI on the risk of local recurrence, distant metastasis and overall—survival in 612 patients between 2003 and 2010 after rectal cancer diagnosis and treatment at the University Hospital Erlangen. A Cox-regression model was used to estimate the hazard ratio and multivariate risk of mortality and distant-metastasis. Median follow up-time was 58 months. Results: Patients with obesity class II or higher (BMI ≥ 35 kg/m2, n = 25) and patients with underweight (BMI < 18.5 kg/m2, n = 5) had reduced overall survival (hazard ratio (HR) = 1.6; 95% confidence interval (CI) 0.9–2.7) as well as higher rates of distant metastases (hazard ratio HR = 1.7; 95% CI 0.9–3.3) as compared to patients with normal bodyweight (18.5 ≤ BMI < 25 kg/m2, n = 209), overweight (25 ≤ BMI <30 kg/m2, n = 257) or obesity class I (30 ≤ BMI <35 kg/m2, n = 102). There were no significant differences for local recurrence. Conclusions: Underweight and excess bodyweight are associated with lower overall survival and higher rates of distant metastasis in patients with rectal cancer.

Randomized Phase III Study Comparing Preoperative Radiotherapy With Chemoradiotherapy in Nonresectable Rectal Cancer

2008 ◽  
Vol 26 (22) ◽  
pp. 3687-3694 ◽  
Author(s):  
Morten Brændengen ◽  
Kjell M. Tveit ◽  
Åke Berglund ◽  
Elke Birkemeyer ◽  
Gunilla Frykholm ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Treatment Failure ◽  
Rectal Carcinoma ◽  
Local Control ◽  
Locally Advanced ◽  
Phase Iii ◽  
Cancer Specific Survival ◽  
Time To Treatment ◽  
Time To Treatment Failure

PurposePreoperative chemoradiotherapy is considered standard treatment for locally advanced rectal cancer, although the scientific evidence for the chemotherapy addition is limited. This trial investigated whether chemotherapy as part of a multidisciplinary treatment approach would improve downstaging, survival, and relapse rate.Patients and MethodsThe randomized study included 207 patients with locally nonresectable T4 primary rectal carcinoma or local recurrence from rectal carcinoma in the period 1996 to 2003. The patients received either chemotherapy (fluorouracil/leucovorin) administered concurrently with radiotherapy (50 Gy) and adjuvant for 16 weeks after surgery (CRT group, n = 98) or radiotherapy alone (50 Gy; RT group, n = 109).ResultsThe two groups were well balanced according to pretreatment characteristics. An R0 resection was performed in 82 patients (84%) in the CRT group and in 74 patients (68%) in the RT group (P = .009). Pathologic complete response was seen in 16% and 7%, respectively. After an R0 + R1 resection, local recurrence was found in 5% and 7%, and distant metastases in 26% and 39%, respectively. Local control (82% v 67% at 5 years; log-rank P = .03), time to treatment failure (63% v 44%; P = .003), cancer-specific survival (72% v 55%; P = .02), and overall survival (66% v 53%; P = .09) all favored the CRT group. Grade 3 or 4 toxicity, mainly GI, was seen in 28 (29%) of 98 and six (6%) of 109, respectively (P = .001). There was no difference in late toxicity.ConclusionCRT improved local control, time to treatment failure, and cancer-specific survival compared with RT alone in patients with nonresectable rectal cancer. The treatments were well tolerated.

Sign in / Sign up

Export Citation Format

Share Document