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. 2022 Jul 28;11(15):4375.
doi: 10.3390/jcm11154375.

Anastomotic Leak Impact on Long-Term Survival after Right Colectomy for Cancer: A Propensity-Score-Matched Analysis

Audrius Dulskas  1   2 , Justas Kuliavas  1   3 , Artiomas Sirvys  2 , Augustinas Bausys  1   2 , Marius Kryzauskas  3   4 , Klaudija Bickaite  2 , Vilius Abeciunas  2 , Tadas Kaminskas  2 , Tomas Poskus  3   4 , Kestutis Strupas  3   4
Affiliations

Anastomotic Leak Impact on Long-Term Survival after Right Colectomy for Cancer: A Propensity-Score-Matched Analysis

Audrius Dulskas et al. J Clin Med. .

Abstract

Our goal was to assess the impact of anastomotic leaks (ALs) on oncologic outcomes using a case-matched analysis. Patients undergoing right hemicolectomy for cancer between 2014 and 2018 were included. The main variables were the risk factor of anastomotic leak, overall survival and disease-free survival. Propensity score matching was performed according to the patient's age, co-morbidities and TNM staging as well as the type of procedure. Oncologic outcomes were analyzed. We included 488 patients and performed final analysis on 69 patients. The AL rate was 4.71% (23 patients). Intrahospital mortality was significantly higher in the AL group, at 1.3% (6 of 465) vs. 8.7% (2 of 23), p = 0.05. Three-year overall survival (OS) in the non-AL group was higher, although the difference could not be considered significant (71.5% vs. 37.3%, p = 0.082); similarly, the likelihood for impaired 3-year progression-free survival (PFS) was lower, but the difference here could also not be considered significant (69.3% vs. 37.3%, p = 0.106). Age, advanced tumor stage, lymph node metastases and distant metastases were associated with higher probability of death or recurrence of disease. In contrast, minimally invasive surgery was associated with lower probability of death (HR (95% CI): 0.99 (0.14-0.72); p = 0.023) and recurrence of disease (HR (95% CI): 0.94 (0.13-0.68); p = 0.020). In an adjusted Cox regression analysis, AL, age and distant metastases were associated with poor long-term survival. Moreover, AL, age and distant metastases were associated with higher probability of recurrence of disease. Based on our results, AL is a significant factor for worse oncologic outcomes. Simple summary: we aimed to assess patients with anastomotic leaks following right hemicolectomy for cancer. These patients were matched to patients without leaks. Propensity score analysis demonstrated that anastomotic leak was a marker of worse oncologic outcomes.

Keywords: anastomotic leak; propensity score matching; right sided hemicolectomy; risk factor; survival rate.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
3-year overall survival (A) and progression-free survival (B) in anastomotic leak (AL) group vs. no leak (non-AL) group.
See this image and copyright information in PMC

References

    1. Ferlay J., Soerjomataram I., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., Bray F. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;136:E359–E386. doi: 10.1002/ijc.29210. - DOI - PubMed
    1. Bashir Mohamed K., Hansen C.H., Krarup P.-M., Fransgård T., Madsen M.T., Gögenur I. The impact of anastomotic leakage on recurrence and long-term survival in patients with colonic cancer: A systematic review and meta-analysis. Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol. 2020;46:439–447. doi: 10.1016/j.ejso.2019.10.038. - DOI - PubMed
    1. Ingeholm P., Gögenur I., Iversen L.H. Danish Colorectal Cancer Group Database. Clin. Epidemiol. 2016;8:465–468. doi: 10.2147/CLEP.S99481. - DOI - PMC - PubMed
    1. Park J.S., Huh J.W., Park Y.A., Cho Y.B., Yun S.H., Kim H.C., Lee W.Y. Risk Factors of Anastomotic Leakage and Long-Term Survival after Colorectal Surgery. Medicine. 2016;95:e2890. doi: 10.1097/MD.0000000000002890. - DOI - PMC - PubMed
    1. Kryzauskas M., Poskus E., Dulskas A., Bausys A., Jakubauskas M., Imbrasaite U., Makunaite G., Kuliavas J., Bausys R., Stratilatovas E., et al. The Problem of Colorectal Anastomosis Safety. Medicine (Baltimore) [(accessed on 24 February 2022)]; Available online: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959889/ - PMC - PubMed

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