The researchers investigated whether anastomotic leakage after anterior resection for rectal carcinoma influences the rate of loco-regional recurrence, and therefore survival.
They reported their findings in the May issue of Colorectal Disease.
The data from 940 patients with invasive rectal carcinoma Stage I-III were analyzed. All were treated by curative anterior resection from 1978 to 1996 at the Department of Surgery of the University of Erlangen.
Patients who received neoadjuvant or adjuvant treatment were excluded, as well as patients who died postoperatively.
89 out of 814 patients (10.9%) were found to develop an anastomotic leakage after anterior resection.
The researchers found the rate of loco-regional recurrence during the first 5 postoperative years of all patients to be 14%.
|Rate of loco-regional cancer recurrence:|
With anastomotic leakage: 22%
Without leakage: 13%
|Colorectal Disease |
In patients with anastomotic leakage, the rate of loco-regional recurrence was 22% - significantly higher than the rate in patients without anastomotic leakage, which was 13%.
On multivariate Cox regression analysis anastomotic leakage was shown to be an independent risk factor for loco-regional recurrence (relative risk: 1.7).
In addition, cancer-related survival was influenced significantly by anastomotic leakage in univariate analysis, as well as in multivariate analysis (relative risk: 1.6).
Dr. S. Merkel, of the University Hospital of Erlangen, Fürth, concluded on behalf of colleagues, "Anastomotic leakage after anterior resection for rectal carcinoma is a risk factor for loco-regional recurrence and decreases cancer-related survival."