The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study

Joshua M Eberhardt, Ravi P Kiran, Ian C Lavery
Diseases of the Colon and Rectum 2009, 52 (3): 380-6

PURPOSE: This study was designed to analyze the impact of anastomotic leak and intra-abdominal abscess on cancer recurrence and survival in patients who underwent resection for colorectal cancer.

METHODS: Data for patients who underwent resection for colon or rectal cancer were retrieved from a prospective colorectal cancer database. Patients with inflammatory bowel disease, familial adenomatous polyposis, hereditary nonpolyposis colorectal cancer, palliative resection, or perioperative mortality were excluded. Patients with postoperative anastomotic leak or intra-abdominal abscess were matched at a 1:2 ratio to patients from the same database who had no leak or abscess. Matched characteristics were age, gender, cancer stage, tumor histology, and operation occurring within three years of each other. Survival and cancer recurrence at five-year follow-up were evaluated with the Kaplan-Meier method and log rank test.

RESULTS: In patients with colon cancer, comparison of the 59 patients with a leak or an abscess with 118 matched controls showed no differences in demographic or treatment characteristics, recurrence, or mortality. In patients with rectal cancer, comparison of the 97 patients with a leak or an abscess with 194 matched controls showed that at five-year follow-up the complication group had higher rates of overall mortality (46.8 vs. 28.9, P < 0.01), cancer-specific mortality (28.7 percent vs. 18.0 percent, P = 0.03), overall recurrence (28.6 vs. 15.7, P = 0.01) and local recurrence (11.0 percent vs. 5.0 percent, P = 0.04).

CONCLUSION: Anastomotic leak and intra-abdominal abscess were not associated with worsened 5-year survival or recurrence in patients who underwent resection for colon cancer. However, these complications were associated with increased overall and cancer-specific mortality and increased overall and local recurrence in patients who underwent resection for rectal cancer.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"