ArticleSurgical endoscopy2020
Long-term oncologic outcomes following anastomotic leak after anterior resection for rectal cancer: does the leak severity matter?
Article in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- When Is a Diverting Stoma Indicated after Low Anterior Resection? A Meta-analysis of Randomized Trials and Meta-Regression of the Risk Factors of Leakage and Complications in Non-Diverted Patients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Pooled it
- Pooled it
- Prevention of anastomotic leak in rectal cancer surgery with local antibiotic decontamination: a prospective, randomized, double-blind, placebo-controlled single center trial.International journal of colorectal disease · 2020Trial
- Does the management of anastomotic leakage after rectal cancer resection affect long-term oncological survival? A retrospective propensity score-adjusted cohort study.Techniques in coloproctology · 2026Observational
- Significance of nodal yield after rectal resection in the TNT era: does count matter?BMC cancer · 2026Article
- Anastomotic Leak Following Colorectal Surgery.Clinics in colon and rectal surgery · 2026Review
- Can Surgical Approach and Postoperative Factors Impact Survival in Rectal Cancer? Robotic Versus Laparoscopic Insights.Cancer medicine · 2025Article
- Clinical prediction model for anastomotic leakage in rectal cancer surgery: a single-center large-sample cohort study.Surgical endoscopy · 2025Article
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- Article
- Risk factors for the failure of endoscopic balloon dilation to manage anastomotic stricture from colorectal surgery: retrospective cohort study.Surgical endoscopy · 2024Article
- Clinical Outcomes of Ileostomy Closure during versus after Adjuvant Chemotherapy in Patients with Rectal Cancer.Canadian journal of gastroenterology & hepatology · 2024Article
- The effect of reinforcing sutures and trans-anal drainage tube on the outcome of laparoscopic resection for rectal cancer: propensity score‑matched analysis.Langenbeck's archives of surgery · 2023Article
- Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery.World journal of gastrointestinal surgery · 2023Review
- Comparison of specimen extraction site and another site for protective loop ileostomy in laparoscopic low anterior rectal resection: a retrospective comparative study.Langenbeck's archives of surgery · 2023Article
- Article
- Risk factors for long-term survival in patients with ypN+ M0 rectal cancer after radical anterior resection.BMC gastroenterology · 2022Article
- Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis.Journal of oncology · 2022Article
- Application of Transurethral Prostate Resection Instrumentation for Treating Low Rectal Anastomotic Leakage: A Pilot Study.Cancer management and research · 2022Article
- Special Considerations of Anastomotic Leak in Patients with Rectal Cancer.Clinics in colon and rectal surgery · 2021Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe evidence regarding the impact of anastomotic leak (AL) after anterior resection (AR) for rectal cancer on oncologic outcomes is controversial, and there are no data about the prognostic relevance of the International Study Group of Rectal Cancer (ISREC) AL classification. The aim was to evaluate the oncologic outcomes in patients with AL after AR for rectal cancer. The prognostic value of the ISREC AL grading system was also investigated.
methodsIt is a retrospective analysis of a prospectively collected database including all patients undergoing curative elective AR for rectal cancer (April 1998-September 2013). AL severity was defined according to the ISREC criteria. A multivariable analysis was performed to identify predictors of poor survival.
resultsA total of 532 patients underwent curative AR (69% laparoscopic) for rectal cancer. The overall AL rate was 7.9%: 15 grade B and 27 grade C ALs. With a median follow-up of 80 (range 12-266) months, 5-year overall survival (OS) was 67.2% in patients with AL and 86.5% in those without AL (P = 0.001). Five-year disease-free survival (DFS) was 50.5% and 80.3%, respectively (P < 0.001). Local recurrence and distant metastases developed more frequently in AL patients (P < 0.05). Grade B AL and no administration or delay of adjuvant chemotherapy were independent predictors for poorer OS and DFS. Grade B AL independently affected also the administration of adjuvant chemotherapy. Circulating C-reactive protein levels at 2 weeks after AL treatment were higher in grade B than grade C patients (P = 0.006) and in patients with tumor relapse (P = 0.011).
conclusionAL after curative AR for rectal cancer and impaired use of adjuvant chemotherapy are associated with poor survival. Postoperative systemic inflammation seems to be more sustained in grade B than that in grade C AL patients, with possible adverse impact on long-term survival.
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